11815 SW KOSKI AVENUE a�
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11815 SW Koski Avenuc
MASTE
CITY OF TIGARD PERMIT
PERMIT
STPERMIT#: MST2UU2-00474
DEVELOPMENT SERVICES DATE_ ISSUED: 12/31/02
13125 SVi Hall BI%Id.,Tigard, OR 97223 (503)639-4171
SITE ADn�<EFS. 11815 SVv KOSKI AVE PARCEL: 1S135CD-KMO10
SL'BD!VISION: KALAMOIIKA ESTATES ZONING: It-I
BLOCK: LOT: 010 JURISDICTION:
REMARK Construction of new SF detached residence. Path 1
BUILDING
REISSUE: STORIES FLOO_PAREAS _REQUIRED SETBACKS REOUIRFD
^LASS OF WORK: NEW HEIGHT 23 FIRST: Ar of BASE.ENT: sf LEFT, SMOKE DETECTORS. v
TYPE OF USE: 61 FLOOR LOAD: SECONDsf GARAGE Sn() at FROIIT q PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: THW RIGHT: 5
VALUE, -?,?r,au
OCCUPANCY ORP: R3 BDRM. 3 BATH: - TOTALsf REAR: 15
_ PLUMBING _
SINKS: I WATER CLOSETS: 3 WASHING MACH LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES -1 DISIIWASHERS: 1 FLOOR DRAINS: SEWER LINES. 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS. GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVN'R. I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<IOOK: 1 BOILI'.MP<AHP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>000K: UNIT HEAFrRS: HOODS: 1 OTHER UNITS: I
MAX INP btu FLOOR FURNANCES: VENTS: 1 WOODSTOVEIN: GAS OUTLETS: 1
ELECTRICAL --
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDER5 BRANCH LIPCUIT9— MISCELLANEOUS ADD'L INSPECTIONS
1000 SF O t LESS: 1 0 -200 ernp 0 -200 amp. Wr9VC OR FDR, PUMPIIRRIGAI'ION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp. 201 400 rnp: Iof WPO 9VCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY. 40 000 amp 401 - 800 amp: EAADOL DR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFUR: 801 1`00 amp: 601+3m1a-l000vt MINOR LABEL!
1000+a npIvolt. PLAN REVIEW SECTION
Reconnect only: >_4 RES UNITS i 9VCIFDR>a225 A.: >800 V NOMINAL: CLS AREAISPC OCC
ELECTRICAL•RESTRICTED ENERGY
A.sr RESIDENTIAL B.COMMERCIAL
AUDl0 S STEREO: x VACUUM dYST'EM: X AUDIO S STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOO9 LNDSC LT:
BURGLAR ALARM: X OTH: Alt ENCOMP BOILER: X HVAC: LANDSCAPEIIRRIG: PROTEC NVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION MEDICAL OTHR:
HVAC. X DATARELE COMM: NURSE CALLS TOTAL 0 SYSTEMS:
TOTAL FEES: $ 6,753.80
Owner: Contractor: This permit is subject to the regulations contained in the
STEVE ECK CONTRUCTION ECK CLNSTRUCTION INC Tigard Municipal Code,State of OR. Specialty Codes and
Ply BOX 204 PO BOX 204 all other applicable laws. All work will Lie done In
SHERWOOD,OR 97140 SHERWCOD,OR 97140 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
Oregon law requires you to follow rules adopted by the
Phone, Phone G25-1305 Oregon Utility Notification Center. Those rules are set
503-625-1305 forth in OAk 952.001-0010 through 952-001-0080. You
Reg a: I I(' I 1 3758 may GDtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 84 Post/Beam Mechanica Mechanical Insp Shear Wsll Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Ins; Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection
Foundation Insp Footing/Foundation Dn Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : >4"`��'�_( Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspe'Aion needed the ne1!t business day
1
CITYOF TIGARD _ SEWER CONNECTION PERMIT -
DEVELOPMENT SERVICES PERMIT#: SWR2002-00318
13125 SW Hall Bi,/d., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/31/02
SITE ADDRE:,S; 11815 SW KOSKI AVE PARCEL: 1S135CD-KM010
SUBDIVISION: KALAM0 11KA FSTATES ZONING: R-12
BLOCK: LOT: nIn JURISDICTION:
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: "JEW DWELLIIIG UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTAL-L TYPE: LTPSWR IMPERV SURFACE:
Rcanarks: hewer connection permit for new SF residence.
Owoer:— -- — �_ �— —_— FEES _...----
STEVE ECK CONTRUCT ON ---- — --
PO BOX 204 Description Date Amount
SHERWOOD, OR 97140 [SWUSA]Swr Connect 12/31/02 $,300.00
[SWUSA] Swr Connect 12/31/02 $0.00
P"one: 503-623-1305 (SWINSP]Swr Inspect 12/31/02 $35.00
[SWINSP) Swr Inspect 12/31/02 $1' 00
Contractor: - --- ---
- ---- -- Total $2,335.00
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 1.ie 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 gi,-en, the installer shall prospect
3 feet in all directions from t!lie distance given. If not so.orated,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: �. � `�9L d '.� Psrrrrittee Signature:
Call (503) 339-4175 by 7:00 P.M. for an inspection needed the nex' business day ~��"~-
f�
Building Permit Application
Date received: Permit no.: p
City of Tigard 1- Project/appl.no.. Expire date:
CiryojTigard Address: 13125 SW Hall Blvd,]W-4131 Oq±3 I
Phone: (503) 639-0171 Date issued: by:; ' Receipt no.:
Fax: (503) 598-1960 I Case file no.: Pa yment type: -
1&2 family:Simple Complex:
Land use approvai: --
I &2 fruniiy dwelling or accessory O Commercial/industrial U Multi-family New construction U Demolition
U Addition/alteiation/replaretnu t U Tenant improvement U hire sprink,iialarm U Other:
Job address: Block:
!J Bldg. no.: Suite no.:
Lo
of / - Block.: Suhdi ision:1�A��1•rp Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: -
Name:
1 &2 family drelling:
Mailing address: .( T 1-56 � •��
City: State: ZII: Valuation of work.. $
Phone: Fax E-mail: No.of bedrooms/baths................................
Owner's represen five: ---- -- - Total number of floors...............................w�
Phone: .Y l-,— E-mail: New dwelling area(sq.ft.) ..........................
Garage/carport area(sq. ft.)......................... „�—---
Name: Covered porch area(.iq.ft.) ......................... (:5-,)
-
Deck area(sa.ft.) ........................................ -
Mailing a:fdress:
State: ZIP: Other structure:rea(sq.ft.).... .................... ._-- _--
City' Commercial/indt►atriaUmultl-famll :
Phone: I.— E-mail:
Valuation of work...... ......................./...... $ _-
Existing bldg.area(sq.ft.) ....Y.'.
.......... --
�4-�tr _
Business name: ,rr'�' -- i!Y New bldg.area(sq.ft.) •.•••.••••
Address: Q Numbst•of stories...... ...........City: ' C'1sZ St•,I• . ZIP: Type of construction..............
P!tone: Z�t-13o� Fax�"�% Email! Occupancy group(s): Existing:
CCP r,).: �L .�-'_ -- -- — — New:
City/meta lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: _52r4/c/ C_� Lr provisions of OILS 701 and may be required to be licensed in the
--- jurisdiction where work is being performed.if the applicant is
Address: �,� �� exempt from licensing,the following reason applies:
City: State: Z1):
Contact person: _ Plan no.:
Fax Email: --
Nrtme: L'�f ��>ritr� Contact person: Fees due upon application ............ ............. $—_
Address: ' Date received: _
City: Stat• ZIP:�7'" Amount received .................... .................... $_-
Phone: '� SfTI Fax: E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all Juritdictioru rccep credit cartL please cdl Jurisdiction for mote Information.
attached checklist.All provisions of laws and ordinances governirrg this U Vice U Mastercard
work will be complied with,whether specified herein or not. 'redit card num1,,; _.�—. —�-- --Expires
Authoriixd signatum: --e-- Dare drown— rune ni rertarolder as on credlr crd T
Print name: /14 — - cwnolaer sl�rwure-� f Amounr
Notice:"Iles permit application expires if a permit is not obtained within 190 days after it has been accepted as complete.
4Y1-M 17(6�OlYCOM)
y
One-and Two-Family Dwelling
quilding Permit Applica♦ion Checklist Reference no.:
!0'7
ASSOC18ted p@fmllR.
17ityofTigard City of Tigard J Electrical U Plumbivi; U Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 I U other: �J
Phone: (503) 639-4171
Fax: (503) 598-1960 r
t X IMAM
I
1 Und use actions completed.See jurisdiction criteria 11 n concurrent revirws• 1
2loning.Flood pl,.n,solar balance points,seismic soil:,I .ignition,historic di,
3 Verification of approved plat/lot.
4 Fire dish ict _- approval required. -- ---- -
5 Septic cyst.m permit or authorization for remodel.Existing system capacity
6 Sewer permit. -
7 Water dfstriot approval.
8 Soils report.Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U pennit required.Include drainage-way protection,silt fea.r.desl�a and location of
catch-ba;in protection,etc.
lU 3 Complete sets of legible pians.Must be drawn to scale,showing conformance to applicable local and state
building codes.Lateral design details and connections must b,incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed
if copyright violations exist.
I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if'
there is more than a 4-11.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot
arca;building coverage area;percentage of coverage;impervious area;existin,;structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor hops,any hold-downs and reinforcing pads,connection details,vent
size and location
iEgimmlicight,
.Show all dimen!ions,room identification,windowsize,location of smoke detectors,water heater,
ntilation fans, lambing fixtures,balconies and decks 30 inches above g.ade,etc.
ons)and details.Show all framing member sizes and spacing such as floor beams,headers,joists,sub-floor,
ction,mof construction.More than one cross section may be required to clearly po,lray construction.Show
l wall and roof sheathing,rooting,rool'slope,ceiling height,siding material,footings and foundation,stairs,
fireI cc construction, the vial insulation,etc.
15 Elevation views.Provide clevationF for new constnrction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foltndation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provi(!e specifications and calculations to engineering standards.
17 )Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered
system see item 22,"Engineer's calculations."
19 Beam calculations.Provide two sets of calculations using current code destgn values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non-uniform load. _
2U Manufactured Ooorlroof truss design details.
21 Energy Code compliance.Idon.ify the preseffptive path or provide calculations.Agas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
23 Five(5)site plans are required for Item I t above. Site plans nnust be 8-1/2"x 11"41, 11"x 17". _
24 Two(2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. -
Ld
26 No rolled,reversed or mirrored building plans will be ac:opted. —
27
28 _
Checkllsi;rust be completed before plan review start date. Minor changes or notes on submitted plans may be in blue 14ackk ink.
Red ink is reserved for department use only.
Electrical Permit Application
Datereceiveo: Permitno.
City of Tigard Project/appl.no.: Expire date:
iry n//7gnrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt nn.:
Phone: (503) 639-4171 Case file no.: Payment type.
Fax: (503) 598-1960
Land use approval: _-----
,
X1 & 2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
_�(Ncw construction (A nildition/alteration/replacenieiit U Other: _ U Partial
JOB
Job address: Bldg. no.. milli:no,; Tax map/tax
�lot/account no.: _
Lot: Block: Subdivision:__�r �(r ---
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
11011"Vixel I
1
rr Max
Job ao: _
----��-- I)cscriplioo 1)ty. (ca.) Total no,Insp
Business nam /.rte Gi*rIre, Air Newrrs: ntial shrgkormulli-ramily per
Address: O� Q __ dwelling unit.InclurtesaltaclKvl9armge.
City: 1/ State' , ZIP: -� Service included:
I(1W sq.ft.or less _ 4 _
Phone: Fax: E-mail: Each additional 500 s .ft.oroortion,&-eof
CCB no.: �� Elec.bus. lic.no: 3-�,3C Limited energy,reaidential 2
City/metro lic.no.: - Limited energy,non-residential 2
Each manufactured home or mo ular dwelling
— Service and/or feeder 2
Signature of su rvising electrician(required) Date _
Services or feeder-Installation,
Sup.elect.name(print) I'cV"IV°` alteration or relocation:
PROPERTY1 200 ramps or less 2
201 amps l0 4(10 amps 2
!Jame(print): -- - — 401 amps to 600 amps 2
Mailing address: — _ _____ 60l amps to IeOo amps 2
Stale: ZIP: over 1000 am s or volts 2
City:
I' Reconnect only I
Phone: Fax: E-mail:
Temporary services or feeders-
Ow=ter installation-The installation is being made on property I own Installation,alteration,orrelocallon:
which is not intended for sale,lease,rent,or exchange according;r= 200 amps or less 2
ORS 447,455 479,670,701. ?01 amps to 400 amps 2
Owner's signature: _ __ Date __. 401 to 600 am s
lei 101 Bench clrcults-new,sltersaon,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
--- ---- 2
Address: service or feeder fee,each branch circuli
State: ZIP: B. Fee for bre--h circuits without purchase
City' ---•- of service or tauter fee,first branch circuit:
Phunc: —_ Entail: Each additional branch circuit 2
t Mbe.(Service or feeder not Included):
Each pump or irrigation rircle _ 2 ._
J Service over 225anips-commercial U Health-care facility Each sign or outlinelighlhg 2--
U Service over 320 amps-rating of 1R2 U Hazardous location signal circuits)or a Itmiiec energy panel,
family dwellings UBuilding over io,o00square f�etfour or signalcircut(s)orali 2
U System over 6W volts nominal more residential units in one structure —�
U Building over three stories U Feeders,400 amps or more •Desai tion:
U lhkcupanl loaf over 99 persons U Manufactured structures or RV park Each additional it spection over the allowable In any of lire above: -_
U Egress/lightingplan ❑Other. _- — Per inspection
Submit_sets of plans with any of the a1mve. Investigation fee
The above are not applicable to temporary construction service. other _
__ — Permit fee.....................$ ----
Nor all fudsdicrions accept credit cards,pleau call jurisdic.ion rot more information. Notice-This permit application Plan review(at ,%) $
U Visa U MasterCard expires if a permit is not obtained
- --
within 180 days after it has been Statc surcharge(8%)....
Credit cad number
apircs occepted as complete TOTAL .......................� ----
None of cudholder u shown on ere t cad Sr
CadholVer 6!e!!_ - Amoum son 4615 INOmK:Oh`
Plumbing Permit Application
Eewer
terecei--:.ct: Permit no.:City of Tigard permit no.: s` Building permit no..
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expiredatc:
City of Tigard phone: (503) 639.4171
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use apps oval: _— case Elbe no.: Payment type:
1113111111
�1 &2 family dwelling or accessory U Commerciallindustrial U Multi-family U Tenant improvement
Ne-N construction U Addi tic n/alterationireplacement U Food service U Other: _
141 -ORMATION
Job address:
Description ' Qty. Fcc(ca.) Total
Suite no.:mi7" New 1-and 2-[arnily dwellings only:
Bldg.no.: � (includes loo ft.for each utifftyconnection)
Tax map/tax lot/accour.t no.: _ SFR(1)bath _
Lot; Block: ^ Subdivision:�f�/r SFR(2)bath
Project name: SFR(3) rtth
Cll /COUnIy:
ZIP: Each addition ath/kitchen
Description and location of work on premises: SiteutWties:
Catch basin/area drain
-- D wells/leach ine/trench drain
Est.date of completion/inspection: Footinpdrain(no. in,ft.)
Manufactured home rtilities
Business name: .4!i7 Manholes
Address: to Rain drain connector
City: _ Stat ZIP; L Sanitary sewer(no.lin.ft.)
Phone: Fax: E-mail: Storm sewer(no.lin.ft.)
Water service(no.lin. ft.)
CCB no.: Plumb.bus.rcg.no:
Fixture or Item:
City/metro tic.no.: Ab-So tion.valve
Contractor's re resentadve signature: Back flow preventer
Print name: FD— ate: Backwater valve
Basinstlavatory
C othes washer _
Name: ishwasher
Address: — Drinking fountain(s) +_ _
City: State: ZIP: l Ejectuts/sump _
Phone: Fax: E-mail: Baoausion tank
Fixture/sewer cad_
Floor dlains/floor sinksRtub _
Name(print): �, Clarba adis sal
Mailing address: Hose bibb _
City: Stat' ZIP: cc m .er
Phone Fax: E-mail Interceptor/grease trap _
Owb er installatwn/residential maintenance only: The actual installation Primer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), ays(s)
Owner's signature; Date: Sump —
Tubs/showcr/shower pan
Urinal
Name: Water closet
Address: Water heater _
City: State: JP: _ _ Other:
Phone: Fax: Email: Tota
Minimum fee................$
Nd oil jurisdicaoru owept credit cutis,Pfau can Jud$&-0011 sur mute bnforndam. Notice:This permit application Plan review(at _ %) $ --
u vea O MasterCard expires if a permit is not obtained State surcharge(8%) ....$ -.-
Credit card number; _, within 180 days after it has been
pra accepted as complete. TOTAL ................... ...$
Nome of urcaroldtr u stwwn on cielii cud $ br
c tioider signature Amount_ 4444616(&WCOM)
Mechanical Permit Application
Date received: Permit no.:.
City of Tigard Project/appl.no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: _ By: Receipt r,�.:
Photic: (503)63941'11 — --
Fax: (5(,1) 598-190 Case Fiileno.: Payment type:
Land Ilse approwl: Building permit no.: �—
I &2 family dwelling or accessory U Commercial/inu tstnal U Multi-family U Tenant improvement
New constntclion U Addilictnlallertltunheplacentcnl U Other:_-- _--_-___----------_---
Job address. '� 'Gc,J -��-C Indicate equipment quantities in boxes below. Indicate the dollar
711dg.no.: I Suite no.: - value of all mechanical materials,equipment,labor,overhead,
Tax map/taxlot/account no.: profit.Value$
Lot: Block: I Subdivision: Cl/,0Af aSce checklist for important application information and
Project name: — ' jurisdiction's fee schedule for residential permit fee.
City/county: —_ I ZIP:
Description and location of work on premises: — l
_ Fee(ea.) Total
Est,date of completion/inspection: Ilrscri Nfon (ry. Rcc.otilv Res.onl
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit --('FM-.,-
Air con utontng(site plan rcqutr )
Is existing space insulated?U Yes U No Alteration of exisungRV77-systcmMECIIANICAll, CON I'll AC'l Oil
m er comnressors
"'..te hoiler permitno:
Business name: eG / -
NP 'tons BTU/H
Address: •ir smo a dampers/duct smoke detectors
City: —!` State: LIP: eat pump(site p an require ) -
Phone: - Fax: I E-mail: nsta I� ce aurnace/burner_— T
----- Including ductwork/vent liner U Yes U No _
CCB no.: nsta rep ace/te ocatc heaters-suspcn ed,
City/metro li no - wall,c Moor mounted
Name(please pnnt):— Vent for a lance otherthan furnace
e era on:
Ahsorptionunits_ 9TU/H
Name: Chillers------ ------ --- HP -
Address: -- CumtressorsHP
V rorunen- 1Texrust and vent ton:
City: - State: "LIP: Appliancevent
Phone: Fax: E-mail: Dryer exhaust - -- —
00 s, ypc1T res. me en amnat-
hocxi fire,suppression system --
Name: �_ _ --_ 8xhaust fan with single duct(bath fans)
Mailing address: �x x iaust system s all rom eaun or C
- ---- -ue1 p ng stoad 40FIbudon(up to 4 out cls)
City: s � State: ZIP_ Type: LPc NG _ Oil
_
Bone Fax: tin earlE-mail- additionalover 4oui eti S— —
kill Ig I to Process piping(sctematicequirc )
Number of outlets
Name: _- �j f•� tj�oppliance or equipment: —! --
Address: Decorative fireplace
City: --- — — Slate: _ ZIP: -nsel— rt—type
Phone: — — Fax: Email oo tov F,9etstove —�--_ _--
tit ter.
Applicant's signature: _ _ Date:
[Name(print): _
Not all Jurisdictions accept credit cards,please call jurisdiction for rt xe information. Permit fee.....................$
❑Visa D Mester(9rd Notice:'Phis permit application Minimum fee................$
expires if a permit is not obtained Plan review(at _ %) $
Credit card number* —__ — Expires — within 180 days after it has been
Slate surcharge(896)....$
Nanr of c older as shown'on c 't card s acvepted as complete.
TOTAL .......................$ .�
iaRnauft Amowt 4404617(60WMNI)
i
ECK
CONSTRUC110N
P.O. Box 204
Sherwood,OR 97140
ELEV; E.EV'.
I LOT 10 I
I
6'-3`
LIVE �(
PROPOSED
RESIDENCE �� �. 10
PLAN#18020
'�f,L10 (REVERSE) I I h
PQ
4-THO< `
1/ 1!fEs_ ' �a DORNE
��
IYW
50.34 -� —
z
S,W. KOSKI DRIVE
`.,UNTEL HOME DESIGN,INC.IS NOT
LIABLE FOR THE ACCURACY OF THE IZ� DUCWTC(l
TOPOGRAPHY INFORMATION. IT IS -- _
THE SOI E RESPONSIBN ITY OF THE TO BE: A'CTACI
01,11LDEi?TO VERI=Y ALL SITE -
r ONDI f IONS.I CI A)ING ANY FILL
PLACED ON THE SITE,AND WORM w..«
OWNti«vF ANY POTS NTIAI. FIELD ...
MODFlCA110NS.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
NORTH STAR PLUMBING
1445 SE OREGON STREET
SHERWOOD, OR 97140
Plumbing Signature Form
Permit #: MST2002-00474
Date Issued: 12/31/02
Parcel: 1 S135CD-KM010
Site Addir.ss: 11815 SW KOSKI AVE
Subdivision: KALAMOIIKA ESTATES
Block: Lot: 010
Jurisdic'cion: TIG
zoning: R-12
Remarks: Construction of new SF 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 Plurnhing S�gnature Form prior to the start of the work to the address above, Al TN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
STEVE ECK CONTRUCTION NORTH STAR PLUMBING
PO BOX 204 1445 SE OREGON STREET
SHERWOOD, OF` 97140 SHERWOOD, OR 97140
Phone #: 503-625-1305 Phone #: 625-2679
Reg #: LIC 00090697
MET 00002694
PLM 34-255PB
AN INK SIGNATI jRF IS REQUIRE ON THIS FORM
ign ure of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext # 310
CITY OF TiGARD
13'125 S.'N. HALL ELVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WILLIAM BUTTERFIELD CONTRACTING
PO BOX 305
13120 SW MORGAN RD
SHERWOOD, OR 97140
Electrical Sigtia�ure Form
Permit #: MST2002-00474
Date Issuers- 12/31/02
Parcel: 1 S135CD-KMO10
Site Address: 11815 SW KOSKI AVE
Sohdivision: KALAMOIIKA ESTATES
31ock: Lot: 010
juilzAiction: TIG
Zoning: R-12
Remarks: Construction of new SF detached residence. Path 1
Your company has been indicated as the E.lec-tri(;al 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 the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER ELECTRICAL CONTRACTOR:
STEVE ECK CONTRUCTION WILLIAM BUTTERFIELD t;ONTRACTINC
PO BOX 204 PO BOX 305
SHERWOOD, OR 97140 13120 SW :MORGAN RD
SHERWOC'), OR 97140
Phone #: 503-625-1305 Phone #: 503-525-6773
Req #: LIC 11855-1
ELI; 3-548(
SUP (14�ls
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervisi g Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITYOF T I � RD PLUMBING PERMIT
DEVELOPMENT SERV� ``�``^. � PERMIT#: PLM2003-)0141
.�..ES DATE ISSUED: 4/15/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171
PARCEL: 1 S135CD-12300
SITE ADDRESS: 11815 SW KOSKI AVE
-12
SUBDIVISION: KALAMOIIKA. ESTATES ZONING: IG
BLOCK: LOT: 010 JURISDICTION: TIG TIG
CLASS OF WORK: .AI_.T GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: CUM WASHING MACH: BACKFLOW PREVNIRS: 1
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES_ LAUNDRY TRAYS: SF RAIN DRAINS:
—--__. - SINKS- URINALS: GREASE TRAPS:
LAVATORIES: OTHEQ FIXTURES:
TL'B/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN O;:AIN: ft
Remarks: Install irrigation backflow preventer -
FEES
Owner: description Date i Amount
STEVE ECK CONTRUCTION [PLUMBI Permit I rr 4/15/03 $36.25
PO BOX 204 ['TAX] 8'!,�State]as 4/15/03 $2.90
SHERWOOD, OR 97140 — =
Total $39.15
Phone . 503-625-1305
Contractor:
GROVER'S LANDSCAPE SERVICES
26485 S. MERIDIAN RD.
AURORA, OR 97002 REQUIRED INSPECTIONS
RP/Backflow Prevenj;r
Phone : 503-678-1796 Sprinkler Final
Reg #: I It 11807
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 through OAR 952-0001-0100.
You may obtain Cores of these rules or direct questions to OUNC by calling (503) 246-66,
r � � _ Permittee Signature:
Issued By: �,--(i'G� �' .� ---
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business d4 y
Building Fixtures
I"Iunibi11 i j!L'I'Iq t AVVINIC�1�I(III Received Plw„I)mg
�-�- 1
Date/n : � `j:U�A Permit No.: LI')I JC
Planning Approval Sewer
City 011 F11.;ard Datc/L) : Perini I.No,
13125 SW I lall Blvd. Plan Review Other -
Tigard,Oreg�n 97223 Date/By: Permit No,:
Post-Review -Case
Use
Phone: 503.639-4171 fax: 503-598-1960 Date/tl : Case No:
lnletit!'L• www.ci.tigard.or.us Contact )wis. ® See PaKc 1 fur
24-hour Inspection Request: 503-639-4175 Namc/Melhod: _ -__[_Su_1Lrental Information.
TYPE OF WORK FEE"SCIIFUULE(fors)eclat information use checklist)
Ncw_construction __ Demolition Descrilrtlon -Tc�t>. Fee(ea.) 'Fatal
L New 1-&2-family dwellings
Addition/alleratitm/replacement OthCr: Includes TOO ft.for each ullllt connection
CA'T'EGORY OF CONSTRUCTION SIR 1 both 249.20
1 &2-Family dwellin Commercial/Indu�Hal Sl-It z bath 350.00
Acccssoi Building Multi-Tamil Sl--R 3 bath 3999)
Master Builder Other: Each additional bath/kitchen 4500
'� JOti SITE INFORMAT N and LOCATION fires rinkler-sq. ft.: Page 2
Job site address: S • Lc/ es" Site Utilities
-- Catch basin/arca drain I6•6II
Suite#: --_ 131d�./A to
#: Dr well/leach line/trench drain 16.60
Pro'ect Name: _ Fooling drain no. linear It) Page 2
Cross street/Directiogs to jot; site: �� ��" � Manufuctured hone utilities 11ll.UO
01A Manholes 16.00
Rain drain conncclo, 16.60
Sanitary sewer(no. linear R. _ l'agi:2
Storm sewer(no.linear ft.) _ Pae 2
Subdivision: Water sere' a nn.linear n. Pae 2
Tax map/parcel #: Fixture or hent
DESCRIPTION OF WORK Ab tion valve _ 16.60
T1.0j Ile l 0Vt�e � A !c'C -E�'> �• - ack(low revcntci_• Page 2
e 11ak1(Water valve 16.60
5 f f N Clothes washer _ 16.60
Dishwasher 16.60
Urinkin fountain 16.60
PROPERTY OWNER TENANT Ejectors/sump _ 16.60 _-
Name_: __ ____ -_ Expansion tank __ 16.60 -
Address: Fixture/sewer cup 16.60
---- Fluor drainToor sink/hub ^-_ 16.60
City/State/Zip: __ Garbage disposal 16.60
phone; l:ax: hose bib _ 16.60
APPLICANT _ �CONTACT PERSON Ice maket 16.60 -
Name: u_ - _-- Interceptor/grease trap 16.60
-- Medical as-value: $ Page e 2
Address: - _ - Primcr - 16.60
city/state/Zip: _ Roofdrain(cotnmct6al) 16.60
P11011c: Sink/basin/levator 1660
---"-
E-mail:il: •lbb%shower/shower 16.60
an
_ CONT'RACTOR Urinul 16.6
�- - Water closet 16.600
E3usinessNamc: �1,m,f:(, v �,
L___.5��� ` 5 r
_ - _ Water heater 16.60
Address: _G , +2�'. ►>�rr, ;hIJ,_ Other: _
Cil /State/Zi '��
c' D Other: _
Plumbing Permit Fern"
Phone: ,Tu 5 d 7�- 17 E 'fax: �� ►r l _ -- _ sn'iotai $
CCN 1.ie j 1'1ut111). 1.IG.#: h ininutn,Permit Fec 572.50 S
J �).
Aulhorized �I_, j <� Residential Backflow Minimum Fee 536.25
Signature: t �� Datc - Plan Review(25%of Pct mit FCC S
State Surchar c(8%of Permit Fec S
- (Please prim name) 1'Oi'AL PF.ItMI h T EE S ?� !_/
Nolice: '1 hip permit application expire%If it perntll N not obtained t%111,11, All nets commercial buildings reyuirc 2 sct%of Plarn with Iwmeu•k or
180 dais after It has been accepted as complete. •fce ciliicllm�lm for g�wtnl>,c,I rl Counit 11ulh1ina Induor)Service(laard.
i\bsts\Permit home\Phnl'erntitApp doc 01/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST _
/l BUP _
Received - [-Date Req4ested {i_� . ��M PM _ BUP _
Location __. [L_ Suite_ _ - MEC
Contact Person --------- Z Ph( ) 1 - I�- PLM
Contractor--___-. -- --- Ph ( ) __- — SWR -- _
BUILDING - Tenant/Owner �_- — ELC
Footing -- ---
Foundation Access: ELC -- -
Ftg Drain ELR
Crawl Drain _ -
Slab Inspection Nates: 5tT
Post& Beard _ —
Shear Anchors
Ext Sheath/Shear I — --------------
Int Sheath/Shear ---
Framing ------- --
Insulation
Drywall Nailing - -----. -- - -----
Firewall
Fire Sprinkler -•
Fire Alarm —
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL -` - ----�- -- -- __
PLUMBING
Post
& Ie — -
Under Slat,
(tough-In __- -------------- ---___.--- -
Water Service
NSanitary Sewer -- ------ --- -
Rain Drair,; - - ---
C.etcl d sin/Manhole - '---- - - -
Storm Drain -- ---
Shower"an
Other: --1-= - --- _
flap
PART FAIL - - -- - - - -- — -- -------- ---
Al FiANICAL --- __--- --
Post& Beam
Rough In ---- -----
,as Line -
Smokc Dampers
Final - --
PASS PART FAIL --- --- - - -
ELECTRICAL
Rough-In
UG/Slab - ----- ---- --- -- ---
Low Voltage -
ire Alarm - - - ----
Final
Reins
PASS PART FAIL Upection fee of$___-_ -_ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd.
SITE — [] Piease call for reinspection RE:-.-_ El Unab-e to inspect-no a,„ess
Fire Supply Line r
j
ADA t
Approach/Sidewalk Date yL_T Inspector Feet
Other:
Final — --- -- DOW REMOVE this Inspection record frorn the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Itispectl-3n Line: (503)639-4175
MST
INSPECTION DIVISION Business; Line: (503)639-4171 --
_ BUP —_
Received 7G1 3C __Date Reque ted ���_. — AM— _PM _—_ BUP _—
Location 1� '/ - 0 ___—.____..__—_Suite _—.__.__—_ MEC
Contact Person _ —___ _ Ph(_ —) �'a U —' ' 1_—_ PLM
Contractor ______ — __ __ Pn SWR
LDI Tenant/Owner ELC
Foo ing ELC
Foundation Access:
Ftg Drain ELR __-
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam ---
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear >
Framing --
Insulation
Drywall Nailing - - -- - - -- _ - - - -- - -__---- -------- _ - - ----
Firewall
Fire Sprinkler —�__ - - _---- ----- - ------ -- ----
Fire Alarm
Susp'd Ceiling -- -- - -- —--
Roof
Ot r_
�rt �
PART FAIL LN—BI h G
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains — ---------- ---- _
Catch Basin/Manhole
Storm Drain
Shower Pan
Other
Final
PASS PART _FAIL
Post d-9�i
Rough-In - - -
Gas Line
Smoke Di3mpers - -
ir_ia�l
4?LSS� PART FAIL
ELECTRICAL—
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm --- --- _-__
Final Reinspcction fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE-_- _ _ _ Unable to inspect-no access
Fire Supply Line
AA
Approach/Sidewalk Date-�—L�G 3 Inspector _ Ext
Oihor:
Final DO HOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
c/ BUP
Received _ Date R quested t AM _ PM— BUP _
Location ._ - �� � .5— � '�- Suite
MEC
Contact Person �'-- Ph( ) G PLM
Contractor - --- — Ph(---) --- —_ SWR _----- —
BUILDING - Tenant/Owner _ ELC
Footing - - -
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam --- -- _--
She?r Anchors -_----- -----
Ext Sheath/Shear
Int Sheath/Shear - --- ----
Framing
Insulation
Drywall Nailing ---- . -__--_- -- --- --_-.__- -- _-__.. ---_-_--
Firewall .._--
Fire Sprinkler - --- -- -- --- -- -- -- ,--- -
Fire Alarm
Susp'd Ceiling -- ----- --- - ---- .. --
Roof
Other: ----- -- --- -------- --- _..--- -- -------.- --
Final
P RT FAIL --- --- -- - - --- ------ -- ----
Post&Beam-- -- _--- —--- -
Under Slab
Rough-In ---�-—_--�---
Water Service -- --- - - - - ------L -- -- _.�
Sanitary Sewer
Rain Drains -- - -- - - �r•� --�- _
Catch Basin/Manhole �`-
Storm Drain -- - - -- --------- . ---- -
Shower Pan _-----'"�� ------- - -�
Other_ --------- -.
Fi-n� - - -
Ssi -PART FAIL - - - ----- ---- - ----- _ ---- _--
Po
Rough-In - --- ---- --- _ - -- -
Gas Line
S e Dampers --- -- -- ---- - _-_.. --
?ART FAIL - -- - -- - -- - ----- --
- ---------- ---------
Set'
RICA
--- _ -- -—
Rough In
UG/Slab
Low Voltage -
Fire Alarm
Reinspection fee of$ required before next inspection. Pa Hall, 13125 SW Hall Blvd.
PART FAIL_ y at City
- Please call for reinspection RE:-_ -- - . Y _ �� Unable to inspect-no access
Fire Supply Line _
ADA G / (_ c
__ ---
Approach/Sidewalk Date -�--[ /�1 Inspector. Ext
_
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL