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-- ROTATED HOUSE TO MAKE THE FRONT r..OHT
V CORNER Ze FROM FRONT PER CUENT, 8/b/01 MSG.
-- ROTATED HOUSE TO MAKE THE FRONT
MORE PARALLEL PER CLIENT. 8/3/01 MSG,
-- NEM HOUSE, D/21m MSG.
SCALE DRAWING LOT 55 ERICKSON HUGHM
S.E. 1/4- SEC. 10, T.2S., RAW., W.M.
CITY OF TIGARD
WASHINGTON COUNTY, OREGON
--A 2.5 FOOT LANDSCAPE EASEMENT SHALL MAY 30; 2001 Centerline Concepts Inc .
EXIST ALONG ALL STRET FRONTAGE, DRAWN BY: l[SG CHECKED BY: WGDiII
--A 7.5 FOOT PUBLIC U1ILITY EASEMENT SCALE 1»=20' ACCOUNT 115 EMAIL WWW.CCiEMAlLOAOL.COM
SHALL EXIST ALONG LANDSCAPE EASEMENT 640 82nd Drive Gladstone, Oregon 97027
M: MLI L55ERICK 503 650-0188 fax 503 6:j0-0189
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ORIGINAL DOCUMENT
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10835 SW Kable Street
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFT'JVORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2001-00448
Date Issued: 9/11/01
Parcel: 2S110DA-09400
Site Address: 10835 SW KABLE ST
Subdivision: ERICKSON HEIGHTS
Block: Lot: 055
Jurisdiction: TIG
Zoning: R-3.5
Remarks: Construction of new single family detached residence. 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 the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC
1672 SW WILLAMETTE FALLS DR 7736 SW NIMBUS AVE
WEST LINN, OR 97068 BEAVERTON, OR 97ons
Phone #: 503-557-8000 Phone 11: 644-8698
Reg #: I it 79666
PI M 20-148PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X a 6t
Signature of Authorized Plumber
If you have any questions, please call (503) 6.39-4171, ext. # 310
CITY OF TIGARD MASTER PERMIT
PERMIT M MST2001-00448
DEVELOPMENT SERVICES DATE ISSUED: 9/11/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10835 SW KABLE ST PARCEL: 2S110DA-09400
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: Construction of new single family detached residence. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK! NEW HEIGHT: 22 FIRST•. 1.514 at BASEMENT. at LEFT: 6 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR L OAD: 40 SECOND: 1.241 at GARAGE: 570 of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLINJI UNITS: I FINBSMENT: of RIGHT: 8
VALUE: 5 274 Dns 00
OLC'JPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: :.855 nn at REAR: 99
_ PLUMBING _
SINKS: 1 WATER C''4E1 S: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: t DISHWASHERS: 1 FLOOR DRAINS: SEWER I-INES: 10(n SF RAIN DRAINS: 1 CATCH BASINS.
TUB11 HOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: lr)n BCKFLW PREVNTR: I GREASE TRAPS:
MECHANICAL OTHER FIXTURES'.
FUEL TYPES Y FURN 100K BOIUCMp<]HP: VENT FANS: 5 CLOTHES DRYER: i
FURN—100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS. 1
MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1
• ELECTRICAL _
RESIDENTI LL UNIT _ SERVICE FrEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS_ MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LL9S: I U 201'amp. 0 200 amp: WISVC OR FDR 1 PUMPIIRRIGATION: PER INSPECTION
EA ADD'L 500SF, fl 201 ;00 amp: 201 400 amp: tot WIO SVC/rDR: rni SIGNIOUT LIN LTPER HOUR.
LIMITED ENERGY: 401 800 amp, 401 600 amp. EA ADDL BR CIW SIGNAL/PANEL: IN PLANT
MANU HMISVCIFDR: 601 • 1000 amp: .101-ampa•1000v: MINOR LABEL.
1000.amp/volt
PLAN REVIEW SECTION
Reconnect only: --
>=4 RES LNITS SVCIFDR-225 A.: >600 V NOMINAL CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL _
UDIO&STEREO. VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM. INTERCOMIPAGING:— OUTDOOR LNDSC LT
BURGLAR ALARM, OTH: BOILER: HVAC: LANDSCAP"RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK. INSTRUMENTATION: MEDICAL OTHR:
HVAC. DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 7,731.60
This permit is subject to the regulations contained in the
RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code,State of OR. Specialty Codes and
1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work will be done in
WEST LINN,OR 97068 WEST LINN,OR 9706ts accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION
Phone: Phone: Oregon law requires you to followrUles adopted by the
Oregon Utility Notification Center. Those rules are set
Rog N: LIC 049955 forth in OAR 952-001.0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Exterior Sheathing Insl Rain drain Insp Plumb Final
Sewer Inspection Underfloor Insulation Plumb Top Out Low Voltage Water Line Insp Final inspection
Footing Insp Crawl Cain/Backwater Electrical Service Gas Line Insp AppNSdwlk Insp
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Fireplace Electrical Final
Post/Beam Structural Pt vi/Underfloor Framing Insp Insulation Insp Mechanical Final
Issued By. u . ; Ll�. Permittee Signature
1
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00227
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/11/01
SITE ADDRESS; 10835 SW KABLE ST PARCEL: 2S110DA-09400
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT: 055 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new single family detached residence.
Owner: FEES
RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt
1672 SW WILLAMETTE. FALLS DR
WEST LINN, OR 97068 PRMT CTR 9/11/01 $2,300.00 27200100000
INSP CTR 9/11/01 $35.00 27200100000
Phone: 503-557-8000 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit 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"Tap and Side Sewer" Perm
Issued by:,/( _ � �'' - Permittee Signature. (-
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Buildijig Permit Application
r S'
Dal,:received:.. $' D �� tenuituo..�O
City of Tigard --- __— -
Project/appl.no.: E spire date:
Cirl'u(/'Ig,n,f Address: 13125 SW hall Blvd,'1'ig:trd,Oil 97223
!Rune: (503) 639-4171 Date issued: _ B,,• Receipt no,:) ___ —
Fax: (503) 598.1960 Case file no.: _ I'aymenttype:
Land use approval: _ l " I&2 fnmily:Simple Complex:
7I &2 family dwelling or accessory U Commercialdindustt .,I U Multi-family `�lew construction U Demolition `
IJ .Adilitiun/alter:uiotJleplacernent U Te.naw inglrovenhrnl U Fire sprinkler/alarrn U Other:
1 1
Job address: � 4.�lE" _ _ _ -- Bldg. no.: ` Suite no.:
f ot_ t�� _---Lt�lt:k: — Suhdtvisiun: � � LG(h'1 S 1'ax.map/tax lot/account no.: /��.-Q 1
Prt,,c.t n�tnh• 3•
lr, nl it n ,111,1 I , t,m of wnik on prerni,rrdspecial conditions:
1 1Ill(!I• M
Nance: � E--S
Mailing .lddre,
11217, WIN 1 &2 lankily dt,clliug:
lilt 7.11' $ .
'C D r aluatiun of work
City �Sl1r* Ll r1 �`-- _�1 -�'2—
Pholl r Fax I., nl _ --� No.of bedrooms/baths........ ......... ............. �-
Owner'.,; rr.presentative: --j'V,ut L. Total number offloors................................. _
_ a
I'll-tne -! >t . li l -Sw' i' New dwelling area(sq. ft.) ................ ........ _._
Guage/catport area(sq. ft.).........................
Nutnc: Covered porch area(sq.rt.) ......................... _--
�+'� Deck area(sq.ft.) ...................................... .
Mailing addlcss:
-- "-- Othotructure luea(sct. ft.
City: Slas
te: ll'. )....... ... ..... ... - -- ..t
Phnnc•; Fax. Email Ctnnntcrciallindustrialltnulti-Gamily:
Valuation of,wurk...................... .... ........... $
Existing bldg.arca(sq. It.) ................. ........
Business❑;unr � _
__ - New bldg.area(sq. ft.) ................. ............
Address: Number of stories
City: _ State: Lll':-- ....................................... --- ——
'Type.of construction.......... �.
Phone: -- Fax: E-mail: Ocru!laicgroup(s): Exlstin
-- t y b'
CCB no.: Now.
City/metro lic nu Notlee:All contractors and subctmtiit,(ors sue tequued to be
« ti t ) y' licensed with the.Oregon Ct RMUClit)rl t'Winact.ors Board under
Nanic: p Q Jy{1 provisions of ORS 701 and may be requitt,d l- he licensed in the
I -_._._ — - — jurisdiction where work is being perfortnrd It the applicant is
Addre!,s. �� -15W �
tl"Lin
ZI f. exempt from licensing,the following reason applies.
Cty �Z -11'61 I`; G �}G�0►, ' www.FvAV
Nance: Gia-- l:OrltaCt person: GkR!Y I•t:es due upon application ......... ... ..... ....... $
Address-7 Z --4— _ _ Date received: _
City: P4T.�lIJ� State: ZII' a7'LO Amount received .........................................
Phone.:�,2 Faa"�. E-mail: 1'I::ase -ofer to fee schedule.
I hereby Cell i I I have read and examined this application and the. Not all jurtuticdoru aeepr credit cards,ptrasa call jutiadctinn aur more inhrmunou
alln.•Ilyd clw- I It 4. All provisions of laws and ordinances govethling this UVisa UMastetCmd
work will be L-aaplied t t whrthrr cite ified herein or no. C.test
F.pi,es
Authorized sl•naurre: T)t'e l � Narne or cmdhorder u.huwn on credit cardT
� S —
Pnot name: — l — --�_-�_-- Cardholder signituir
Notice:This pennil application c,t n es i f a pennit is not obtained within 180 days after it has been accepted as complete. 1404613 triAX.VCohtj
Electrical Permit Application
Dile receive":
City of "Figurd �- Perflut Ilu':
Ci1v kj Tiga I d address: 13125 SW IIAI Blvd,Tigard,OR 97223 PrujecUuppI.ILt..: Expire.date;
Pholw: (503) 639-4 171 Dale issued: -��7z.
(503) 598-1960
Case file uo.: Payment type..
Laud use uj)provW:
V% & I ,(
JIIIIY dwelling or accessory U('0111111CIcial/industrial
U AdditiorValterutinn/repla�:rnlrnt IJ 13th,,.'.. Tenant improvcmellf
U PaIlla-I
Jub address:
Suite n.. i'l-ILk Inapitax lol./accouill
MR
L, Subdivision:
L
Ut work 011 plenilse-,
IVL�
lij 1!IN III
Job mit:
Busill';SS 1111flic:
Fee MAX
AddCCss (C-)
Sax
'Weltillig 106L Ineludes stlaclied gairrage.
—
Piton SU) Dz I A Stniceincluded.
1000 sq.h uj less
CCD U.: i, c,bus,ji Rich dirional SdU--,q
Rach portion rhuwf 4
C.no:
I-Irillied energy,ics delaial
_Irfdtcd energy,non-re4iijell-11al —
Each marairacluird holne
or modular dwelling
(required) 6;(-a- SCrvice andlor leeder
,;III, Heel
mom�
allerliflual or relocation:
200 until$or im
Name (print): F-L 6 LA I Al� V 201 allips to 400 ajilps-
2
addl, 401 0111ps to 6GU amps
LIV-1—2---* -W-- 15 -- — 2
co, 601 anips to I Oijo Lollps 2
Over IVDU 4111ps
Reconnect only —2
(T n ,Wldtiull:The installation is being made on property I own ellipoilrY se-11-1ces-OW-fe—eders
will, It I>It'll intended fur sal,-, lease,rent,Or exchange according to bl"Im"'111011,"Itermllon,or relucall"ll:
URS 447,455, 479 6 I 1 200,allps or less
1 t Imi"I" .12111 amps—1.41.10 amps 01 4111 to min
Name. C6A tevi,alleru I—,.,
or extermloo Iter panel..
Athirr LAJ A. Fee cot branch circuits with Purchase of
'ity: vice or fet-der fee each branch circuit
31 - L
-1 J--W
--T;I
Slat
IT,A� 0 - - -d �.�47-j --richcm%ots 2
tchue
-Ill 0-041,5 1" mail: of scrvic-�or tieele,ICC,First brunch circuit:
Fath additional bi wich co cull:
V ILI Ajyj
mlls�C7(selrvwcii or feeder notIncluded):Lj Sel-VICC UVCl 22)A1111h t:uILlincrtaul Ll Health.clueflicifily Each pump or Imp
U Service over 320 allips-turing of 1&2 tion circle
U Hazardous locinjo 2
j1-:1!:11 31 n�ur uUjrh:�1,g ani#
7 11 7 2
Urals in mie structure W'
Q Building aver 10 000 square feet last at Signal circuit($)or a li
U Sys"ll uver(Ak)volts noininal more residential' Mile energy panel,
U BolUng over three stories Q Feeders,400 amps or mate alteration,or extenslon*
U Uccupaill load over 99 Pellons 4,1) - - 2
U ElItest/lighmigplail tylaltur"cluted struchnes or RV oak cri tion
Lithel Eich addillatual lltspectlnn over the Allo"NUIC U1 any of Illy above:
Subtutt sets,or pilI with any ortile ab.... Per Inspection
The above are 1101 Applicable to Ital"porlitry construction set-Vice. estigauan ice
Nor all Jwitdicliwls ---------
t1lel"'—17MUL1,PICUd call illfbittrej Pur
------------
U MWICIVArd n Notice:This permit application Perini,fee.................... $
Cicclil cot)number: expires if 8 permit is not obtained Plan review(a[ %)
Elipires within ISO days after it has been Slate surctlarge $
accepted as complete, TOTAL
CWJhUI Cl crinalure
L
44U-461 5(61WCOrI1
hilli>Ibin; Permit Application
City of Tigard 1 rDwerece!ived: g /� p/ permit no.:Address: 13125 SW' F1a.11 Blvd,Ti•ard,OR 97223 permit no,: Buildingpelmit no.:
C'rtvuJ7i);rar1
I'llone: (503) 639-4171
Praject/nppLnu.: E:xpiredate:
Fax: (503) 598-1960 --
Date issued: By: Receipt no,:
Land use approval: Case rile no.: ,
I ayrnenl type:
f
1 &2 fandly dwelling or accessory U CornnierciaUindustrial
Cw construch 11 U ,, I liriun/alteration/replacement 0 Mul) sr milt' L7 Tenant improvement
D 00101:
Job address_ r-7
/L'Z� . ! est 1 i (tion
Bldg nu. i1"� - --- �—. Qtl_ I ec(ca.) Twill
;�u1t, nu : Nett'1-and 2-funiily dnelWtgs Duly: _�
Tal n';1ph;x Int/;,
u nt no.: (includes FOO it.fur lsr(h utility counectiou)
f� 1^ l:;i l livisinti SF li(1)bath
SFR(2)bath _
_. E�J `` '�_ }� (_A_HT� srrr, (3j barn
C ty/county: -
�] .� - 11 additional batlUl.ltchen -
Description and lu�:ation ul'wart:un promises:_ �—`----
S�'S'[)1.L,tT I F� Site utilities:
('arch basir/aiea drain
list. durrt c1f complr_tiun/inspection: Drywells/leach line/trench drain --
f f r Footing drain Q►o.lin.ft•)
Business name: G �T�-�v Manufactured home utilities
Vt'*�-- - Mwtholes
Addres,, '1'1!)`U -- IM�, �, -
Rain drain connector
City: VE� w 1JStatc: ZIP: — - _
_. -_�1 ant sewer(no.lin. ft.) -
Fa - F-n1aif. _ Storm sewer(nu,lin.f►.)
CCB r"' 7 C.l�t'r Plumb,bus. reg.nu: LG��4 Water service(no. lin. fL) -
Fixture or item:
Cunuactul':, i. iii •nurti r signarul~ --- -- -' Absorption valve.
Print n:u1v pr- QCf: ILC) hate: Back flow preventer — -
f f Backwater valve
Basins/layatury
Clothes washer - -
- E -
--- -
Address: _ Dishwasher � --
Cily: 1" _�5tateZ,1,7-----
Dunkin fountriin(s)
Phone IIx Ejectors/surnp
I' mail
Expansion tank — -
Ct,1 Fixture/sewer :ap " - -
Name(print): R Ghr�r��4i� T-1
----
_ l lour drains/floor sinksAiub -
hlailinK addrrss IJAL I*w�i Garbage isposal -
City:JA _ State: _ GIP -Close bibb
Phone: - -N I.a _.-
L F-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Ynttler(s)
will be made by me r,r th maintenance t►i1d repair made by my rcgulw Roof drain(cpmmercial)
employee on Ore pt,11 ! awn as per ORS Chapter 447. -
Owner's signature, �.--- - Sink(s),basin(s), lays(s) -
DatO: Sump
Tubs/shower/shower pan
Natne: 46A Urinal
Addre,, 1 — - —- Water closet
�J �.1i __
C1t .'(1-r�tN� - ___-__ atcn�—heater —'----- -
Ph.n„• ��f
_ - -_- ►`'cr. E-mail: F'otul
-- — --
Nor alt furictions accept credit cods,plraae cal juri:.11c0un for mote iNonturlun.
U Visa wliU MasterCard Notice:11us peen t application b1lnirnuln lee................$ --
Credn card number. expires if pennit is not obtained Phil review(at a %) $
within 180 days after it has been State sun harge(8'8,) ....$ --
------ Expires Nurse of cardholder as ahriwn nn credit cu'd -`—-`--'-
accepted as complete. "TOTAL .......................9
Cardholdersignammre -
�__ Amount
440 4616(ts)O COM)
Mechanical Pernut Application
Daictrreived: /O p/ permiln„
City of i lgard ProjeeUappl.nu.: Expire date. -A
City Of l'ig.it-d Address: 13125 SW Hall Blvd,Tigard,Ult 97223 --
1 Iwne: (503) 639-4171 Date issued: By;
Fax: (503) 598-1960 Case file no.: Payment I l
Land use apl)roval: Building permit no_
f
)<I &'2 family dwelling or accessory U Con it,ercwl/u+dustrial U Mulu-lanuly U Tenant impio>"111"11l
XNew ccroslnicul,n U Add i�o+/alteralion/replaccnient Ij Od11!1- -
JOB SITE INFORMATIONt I
Job addres g'�`J K' FG SI• _ _ Indicate equipment quantities in huaes below. lndic;ue tl+-'d li,u
Bldg. no.: Jtute no t.� _Y value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/accuunt nu.: profit. Value$
Lot: 61"' Block: _ Subdivision:rjL *See checklist for impor'tunt application iuforrll, 1111i and
Project name: hili.-dl,'lion's fee schedule fur residential perm l I-
C
',•
City/county �( ZIP: _ DWELLING IPEDW FEE K , :al
Description and location of work an prenuses:
Est.dtuc of'cumpletion/iiispection: Description Qty. Rm.otdv kc,.,,IIh
Tenant ulynovement or change of use: `—� -- HVAC: --Is existing space heated or c,,ii lutoned?U Yes U No Air handling unit ___(:FM
Is emstint, spar n, ul:u t'" I „ U N Airconditioning(site plan required)
Alteration o existing VAC system _
61 pro;F.10 DO •a tBoiler/compressors
Business name. (��{ �� - - N(^ State hoilerpermltno.:
--- � ._ HP Tons
---- ----_--
--Llll/
l
{
Address:- ire/snwr me-s/3uct smoke erectors
Fin-�0state; LII': q� Z� an required)
Pht)ue/?A 1„TP-_ nstal replacefurnace/wrner BT /
- - --- - Including duetwork/vent liner U Yes U No
('l It 1°� jov __. _.� _- nstall/replace re ucateheuters-snspende , -_
('I! nl•II„lir nil wall,or floor mounted
em for app iiunceoilier then furnace -
e rigeralion:
-�� Absnrpuun units_- - }3TU/H
Ntlltte; Chillers `— HP
_LL_.
'Addrass.
Coln ire YSnrS
nvironwenta exhaust and venlilalion:
City: ��--- - State: 'LLP: Appliancevew
f'll";r lv .I l` mail' 5ryerexhaust --- -
t ti,
Hoods,Type res. kitchen/haamat
hood fire suppression sy.ient
N:+n r ' �,A ----- Lxhaust fan with single duct(bath fans)
ss 1 � ���ry'�
Exhaust systema arr�rom reaung or ACS -
�/ Fuelpiping audistribution(up to 4 out ets)-
C
Type: LPG Id: _� Ohl
-- —
�Iipi over 4 cutlets
Process piping(schematicrequire.t)
N;un Cfj Number of outlets _
tit tertr appliance pliance oreyt-ii pmenti
Address 3rz1 wLtr'1 _--- Drc:orativefireplace _
FQ�.�1+O�1�1�j 5tare:(�,�zll' ����' - insert-type
n ul: -}--- oodstove pe et stove -
Al,l
5th
(
titer:r: _
Not.dl i uisdicuwn accept credit cods,pc is
le call junAmion for Inure inronnetioa. — ---
Notice: Permit fee.....................
U`I,a U 'Chis permit application Ivlinimurn fee.. . ...........
beer- clCaid expires if a permit is not obtained —�
I'rodn c:ud number- _L 1__ t ian review(at
r.r.
within 180 days after it ha4 been
WIT
_ _ State.surcharge(8%) ....$ _
Nnme of cur holder o ahuwn on it IT d accepted as complete.
____ Cardholder tignalurc ^-- �— amount arn�e t'i wxa'CUtsn
SEE 35MM
ROLL # 20
FOR.
OVERSIZED
DOCUMENT
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GAGE ENTERPRISES INC
PO BOX 1429
CLACKAMAS, OR 97015-1429
Electrical Signature Form
Permit #: MST2001-00448
Date Issued: 9111/01
Parcel: 2S110DA-09400
Site Address: 10835 SW KABLE ST
Subdivision: ERICKSON HEIGHTS
Block: Lot: 055
Jurisdiction: TIG
Zoning: R-3.5
Remarks: Construction of new single family detached residence. Path 1
Your company has been indicated as the electrical contractor fci 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 the � ork to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
RENAISSANCE CUSTOM HOMES GAGE ENTERPRISES INC
1672 SW WILLAMETTE FALLS DR PO BOX 1429
WEST LINN, OR 97n6e CLACKAMAS. OR 97015-1429
Phone #: 503-557-8000 Phone #: 503-657-0142
Reg #: 3uF 6185
LIC 34544
ELE 3-128C
AN INK SIGNATURE IS REQUIRED 014 THIS FORM
Signature of Supervising E ectrician
If you have any questions, please call (503) 639-4171, ext. # 310
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CITYOF T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P /15/2001
00387
DATE ISSUED: 08/15/20
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S110DA-09400
SITE ADDRESS: 10835 SW KABLE ST
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT: 055 _ JURISDICTION: TIG
CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of back flow preventer device.
FEES
Owner: Type By Date Amount Receipt
RENAISSANCE HOMES PRMT CTR 08/1512001 $36.25 27200100000
1672 SW WILLAMETTE FALLS DR. 5PCT CTR 08/15/2001 $2.90 27200100000
WEST LINN, OR 97068 -- —
Total $39.15
Phone 1: 503-557-8000
Contractor:
MOODY ENTERPRISES INC
PO BOX 713
ESTACADA, OR 97023 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone 1: 503-630-5532 Final Inspecticio
Reg #: LIC 5973
PLM 11717
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work iS suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 thrnugh OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: ll. �� .�� Permittee Signature_ y
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbing Permit AApplication
City of Tigard
/T Date received: I Perrnil no.;
'j
Address: 13125"W Hall Blvd,'fR 97223 Sewerpermit o.: Building permit no.;
Cirvoingard phone: (503) 639-4171 Project/appl,no.; Expire date:
Fax: (503) 598-1960 Date issued: Hy: Receipt no.:
Land use approval: Case rite no.: Payment type:
V l &2 family dwelling or accessory U Commercial/industrial U !Audi-family U Tenant iinprc,venrent
d New ccrostntclion U Addition/alle.ration/replaceincnt U food service U(Aher:
.1011 S111 F,IN FORMATION, 111-11', *11EMILE(for special Information use checkl6l)
Job address: O.y ") f Ui Description Qty.I Fee ea. Total
Bldg.no.: Suite no.: --- -— New 1-and 2-family dwellings only:
Tan map/tax lot/account no.: (Includes 100 ft.roreach utility connection)
SFR(1)bath
Lot: -5, Block: Subdivision: _ S,R(2)bath ---- - - J- ---
Project name: i r'..Lt SFR(3)bath
City/county: cG •n a, ZW:' 2 Z Each additional both/kitchen
Description and location of work on premises: i'itN�1/�c s _ Siteudllties:
Catch basin/area drain
hSI,dale of completion/inspection D►ywells/leach inc/trenchrain n - -
Fooling drain(no.lin. ft.)
Manufactured home utilities
Business name:, L'` (L ;,I !, tip, _ Manholes -- -
Address: .f� /. Rain drain connector
City: State-' I ZIP: 27C 2--3 Sanitary sewer(no.lin.ft.)
Fx: •,r.,)e E-mail: Storm sewer(no.lin.f.)yfPhoneY 3c)
CCA no.: /17 Plumb.bus.reg.no: 5' Water service(no. lin.ft.)
Cit /metro Iia no.: Fixture or item:
Contractor's representative signature: / ! o ,� — Absorption valve
Print name:: n, ) �r�tDate: Backwater valve
, ,•i �/ Back flow preventer
_
Basins/lavatory
Name: G Clothes washer
r•fiC 1/ -o�(
Dishwasher
Address: ,�° ' 7/„1 ----- -- ---
brinking fountain(s)
City: L-9 rc-ege- cStatec,/4 ZIP: "�3 Ejectors/sump
Phone: ; 3-Cjc•, �1 Fax: r<< t'c E-mail: Expansion tank -
Fixture/sewer cap _
Name(print) ?44 - Floor drains/floor sinksthub- --" -
Mailing address: �/ �W W/��{, Hose Garbage disposal _-
• Huse bibb
City: — state: L! _ - Ice maker —
Phone. • "'I Fax: I:-mail' Interceptor/grease trap —
Owner instaliation/residential maintenance only: The nctu: installation Primer(s)
I will be made by me o re intenance and repair made by my regular Roof gain(commercial)
employee on the p eil I w m per ORS C Ater 447. si—nes)Tiasin(s), lays(s)
Owner's signature: Date: r' Sump
Tub0hower/shower pail -
Urinal
Name: -- - ---- Water closet -- -
Addres.z: Water heater
City: --- -- State: ZIP: Other:
Phone: Fox: Email: Coral
Not all jurisdictions accept credit cards,please call Jurisdiction rut more inrortnation. Notice:This permit application Minimum fee................$
U Visa U MasterCard expires if a permit is not obtained Plan review(6t __ %) $
Credit cud number: _1—_L_ State surcharge(8%) . —$
I x ices within IRO days after it has been -- -
accepted as complete.Nerve of of r u shown on ere Lard TOTAL .......................$p P
Cardholder Upunue --- ---Amount--
---_-,� 4141616(6d)0lCOM)
CITY OF TIGARD BUILDING INSIJECTICN DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
_ Date Requested •3- Ze) AM� PM BLD
Location ✓ ,S SiSuite _ MEC T _
Contact Person — Ph — -y e Z- - PLM
Contractor Ph SWR
UI- ----- Tenant/Owner ELC
Retaining Wall — ELR
Footing Access: - -- -------
Foundation FPS _
Ftg Drain — --�—
Crawl Drain Inspection Notes: SIGN —`
Slab -- - - — _ - -- -- SIT
Post& Beam - - --
Ext Sheatl,/Shear _
Int Sheatl Shear --
Framing ,1- ___--
Insulation - ------_._ _.
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _--
ina
ASS PART FAIL -------- --. —_— —.--_--------- --
PLUMBING
I'ost& Beam - - -- __-- - ---- ----------
Under Slab
Top Out
Water Service
Sanitary Sewer -
Rain Drains
- - ----_
Final ----
PASS PART FAIL
QH
Post R Beam --
Rough In
Gas Line - ---- - - ----- - -
Smoke Dampers
ASS PART FAIL
ELECTRICAL - .. - -- -------- - —--—
Service
Rough In -- -------- -- -
UG/SlabLow Vo0age ---- - --..------
Fire Alarm
Final _-
PASS PART FAIL -_-_--
SITE
Backfill/Grading
Sanitary Sewer
Storm Dre'. I :leinspection fee of$ _required before next inspection. Pav at City Hall, 13125 SW Hall Blvd
Catch Rn in
Fire Su,my Line ( I Please call for reinspection RE: _ -� [ ] Unable to inspect-no access
ADA
Approach/Sidewalk
Other Dete �__2- 1;2 r,1 Inspector — —Ext
Final
PASS PART FAIL DO NOT REMOVE finis inspection record from the job site.
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CONSULTING ENGINEERS
ENGINEERING EXCELLENCE
October 9, 2001
RECD oCT 10 2001
Steve Ilunt
Renaissance Development
1672 SW Willamette Falls Dr.
West Linn,OR 97068
To: Steve l lunt, Renaissance Development
From: Ryan F:. Paddock, CSA Consulting Engineers
Re: Footing Clarification, Plan #11I1-99-135,Cundall l3, Lot #55 F rickson Heights.CSA Joh
#2736.
A continuous footing is not required below the main Iloor shear wall located hetween the (lei)
and family room. The shear load can he transferred through the floor diaphragm to the perirnctcr
foundation walls,
Retrr to the enclosed main floor shear wall plan for clarification of location.
Cordially,
CSA Consulting Engineers
"Ryan E. Paddock,P.E.
321 S.W. 4th, 4th Floor• Portland, Oregon 97204
(503)228-3848 E-mail:csaOcnnw.net FAX (503)228-0475
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AAll S6(u tells
24-
r11'y OF TIGARD InsHour
nspection Line: (503)639-4175 MST lYw� ��
BUILDING Business Line: (503)639-4171 BUP
INSPECTION DIVISION
PM B1JP
Received Date Requested_ AM MEC
7 Suite� Kar��- ..� _ _ __
Location Ph(- —) j /6, '- PLM —
Contact Person __ SWR
Contractor ._-- —_— Ph ELC -- ------
BUILDING
---BUILDING TenanVOwner -
Footing ELR -
Foundation Lnspection
Fig Drain _ SIT -----
Crawl Drain
Slab Notes:
Post&Beam - -
- - -
Shear Anchors - -
Ext Sheath/Shear -- -"-
Int Sheath/Shear
Framing - -
-----------
Insulation - --�
Drywall Nailing
Firewall _-4� �. -,-__---,
�`
Fire Sprinkler --�� � A_� --------
Fire Alarm -
Suslid Ceiling
Rooi -------- -
Other: - -- -- ------ -
Final -- - -- --
PASS. PART FAIL ---------
,pL:UM —
*:s::f& Beam - -- ---'� ---------
Under Slab ----
Rough-In _
Water Service - --
Sanitary Sewe -_ -- _-
Rain Drains _ _ -
Catch Basin/Manhole - -T___. -
Storm Drain --- - -
Shower Pan ----
Other: -- -----` ------
final
SS PART FAIL
M_ ANICAL - - -
Post& Beam - -- - ----- -
Rough-In -- - -
Gac Line --
Srnore Dampers ---- -
-----------
Final
PASS PART FAIL -
ELECTRICAL----- - - - --
Service _ --- ---- --- _- _.-_
Rough-In - -
UG/Slab
Low Voltage -
FireAlarmrequired before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
a
Fin �� Reinspection fee of$
�l Unable to inspect--no access
`-PASS PART FAIL
SITE Please call for reinspection RE: -(_---�
---
Fire Supply Line Inspector Ext
ADA _. �_-
Date _ �(
Approach/Sidewalk job site.
Other: - DO NOT REMOVE this Inspection record from the J
Final
PASS PART FAIL