12857 SW KAMERON WAY i
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12857 5W KAMEFON WAY
C I TY O F T I G A R D MASTER PERMIT --
PERMIT#: MST99-0610�
DEVELOPMENT SERVICES DATE ISSUED: 6/1/99
13125 SW Hall Blytl., Tigard, OR 97223 (503) 639-4171
SITE Ar)DRESS;_42F147 SW KAi.1ERON WY PARr:EL: 2S105AD-04300
SUBDIVISIOk SCHOLLS MEADOWS ZONING: R-25
BLOCK: LOT: 009 J JR:SDICTION: URB
REMARr:_-: PATH I: New single family dwelling w/attached garage.
BUILDING
RF SSUE: .OFIES: FLOOR ARFAS REQUIRED SETBA.;KS REQUIRED
CLASS OF WORK: NEW HEIGHT: :.2 FIP9T: 778 of BASEMENT: (,r1 of LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: du SECONL 938 of GARAGE: 41,P of FRONT: 20 "ARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: 0 of RIGHT:
VALUE: s 17t7 ran on
OCCUPANCY GRP: R3 BDRM: BATH: 3 TOTAL: 1,718.00 of REAR: 20
PLUMBING
SINKS: 1 WATER CLOSETS. 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN. Inn TRAPS: 0
LAVATORIES: 4 DISHWASHERS. I FLOOR 114AINS: 0 SEWER LINES: 100 SF RAIN DRAINS: I CATCH DASINS: 0
TUNgHOWERS: 2 G4RBAGE OISP: I WATER Hf ATER£: I WATER LINES: I1110 8CKFLW PREVNTR: I GREASE TRAPS I
01 HER FIXTURES: 0
MECHANICAL
FUEL T"PES r FURN r 100K. I BOILICMP<3HP: 0 VENT FANS: 4 CLOT WS DRYER: I
GAS FI IRN>=WOW C' UNIT HEATERS: - NJODS: i OTHER UNITS: I
MAX INP: 0 btu FLUOR FURNANCES: 9 VF"NTS: G' WOODSTOVES: 0 GAS OUTLETS: I
ELECTRICAL.
RESIDENTIAL UNIT SERVICE SEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
In00 SF OR LESS 1 0 200 amp. 0 0 200 amp: 0 WISVC OR FURI PUMPIIRRIGATION: 0 PER INSPECTION. 0
EA ADD'L 500SF: 3 201 400 amp: n 201 400 amp: 0 let WIO SVCIFDR: nn SIGNIOUT LIN LT: 0 PER HOUR: 0
LIMITED EuFRGY: 0 401 800 amp: a 401 - 000 amp: 0 EA ADDL SR CIRC 0 SIGNAL/PANEL: 0 IN PLANT: n
MANU HMISVCirDR: 0 601 - %Cn amp: 0 601 amp-1•1000v: 0 MINOR LABEL: 0
10001 amplvolt.
PLAN REVIEW SSCTION
Reconnect only: 0
-4 RES UNITS: SVCIFDR>=225 A: >600 V NuMINAL: CLS AREA/SPC OCC:
ELECTR'CAL RESTRICTED ENERGY
A.SF RESIDENTIAL B,COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO FIRE At-ARM, INTERCOMIPAGING: OUTDOOR,LNDSC L r.
BURGLAR ALARM OTH. bolk ER: HVAC: LANDSCAPLnRRIG: PROTECTIVE SIGNL.
GARAGE OPENER. CLOCK: INSTRUMENTATIO.1: MEDICAL: OTHR.
HVAC: DATAfTELE COME': NURSE CALLS TOTAL 0 SYSTEMS: 0
Owner: Contractor: TOTAL FEES: $ 3,451.41
This permit IS subject to the regulations contained in tho
ESLINGER BUILDEPS IWC ESLING" R BUILDERS INC Tigard Municipal Code,State of OR Specialty Codes and
15836 SW UPPER,POUNES FERRY RO 15836 SW UPPER BOONES FEr'RY Fall other applicable laws All work will be done in
LAKE OSWEGC',OR 97035 LAKE OSWE1--),OR 97035
accordance with approved plans. This permit will expire If
.,ark is riot started within 180 days of issuance,or if the
work is suspended fo�more than 180 days ATTENTION
Phone: Phone: Ore ion law requires you to follow rules adopted by the
01L-n,^n Utility Notification Center. Those rules are set
Rep forth in OAR 952-001-001C through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion 844-8444 Crawl Gain/Backwater Electrical Rouo` in Insulation Im,p Electrical Final
Footing Insp PLM/Underfloor Framing In.-,) Rain drab.1 1 Mechanical Final
Foundation Insp Mechanical Insp Shear Wall Insp Water Service Insp Plumb Final ORIGINAL
Post/Beam Structural Plumu Top Out Low Voltage l.ppr/Sdwlk Insp Building Final
Post/Beam Mechanica Electrical Service Gas L Insp — Urb St Tree Certif Ltr F —
�I
Issued By : (�� �� I^- -"--__-� Permittee Signature :—SLC,,) —
all (503) 639-4175 by 7:00 p.m ;vr all inspectill n needed the next business day"
GI t"Y OF TIGARD Residential Building Permit Application Plan ec �
13125 SW HALL BLVD. Additions or Alterations Rec' ey�k
TIGARD, OR 9722.3 Single f=amily Det.iched or Attached (Duplex) Date Recd_ -/6- 72
V 503-639-4171 Date to P.E.1',46- -4—
Dale to DST�-s;VR -r
F 503-6134-7297 u ��� Permit
Print or Type .'!� Called
Incomplete or illegible applications will not be cceptodVA4
r �.
(Jame of Proje t — ` _ —r'N- — --
Job
lldrd
Address Site Addddre's—s� e Architect Mailin A,dddress
— _ 1 m �o �Ci�y/S�te J J_ip P�ne
S i n �C�'_U r i CdPrS C 11 _k2k Gnl��72 Z �.'L -9,?S�
Owner Mailing Add sr� s -----� � Nan
13
D �Q r GLS' F'Y
Cf /Stale phone Engineer Mailing Address
to -RUT ell / ---
General Name y Stale Zip Phone
Contractor 1�Y: Describe work Nnw Addition U Alleralion O Repair U
Mailing ddress LLto be done: -
Prior to permit / 6 "-w-vow =//--
� Additional Descrip'.ion of Work.
issuance,a copy Cily/Slate Zip Phone ��� j M/ � 1
of all licenses ��� (k 0�� � r
a,a required i! Oregon const. bill. oard Exp.tale PROJe.CT
aspired In cor Lic.#�� ?��3 �!�/ VALIDATION $/,q3 �-
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- e r`t��Ul� t _G� Sq. FI. House: /_ Sq. Fl. Garage --- -
Contractor
Mailing Address �7`((J--I
Prior to permit s Indicate W a restricted energy in;dallalion by the electrical
Issuance,a conCity/Stale Zip Phone subcontra�lur in the following areas
of all licenses' P� �*D2 9716 , 3_7 Restricted Audio/Stereo
are required If Oregon Const.Cont. Board Exp. Dale Energy System Alarms
expired in COT Lic.# /1 Installations Vacuum Irrigation
database ry 21130 q9 _ -System S stem
!'lumbginName (check all that Other:
Sui: C , apply)
Contractor Mailing Address - Corner Lot YES NO Flag Lot- YES N(�
_ check one (check one)
Prior to pennll City/State Zi Phone
4( r I !-!os the Subdivision P!at recorded? N/A YES NO
issuance,a copy of all licenses arc Oregon Const.Cont.Board Exp.Date
required if I.Ic.0 / ___
expired In COT ?6.V 2 ip 2 (�Q I hearby acknowledge that I have read this opplicallon,that the
database Plumbing Lie.h" Exp,Dae informal on given Is correct,that I am the owner or authorized agent
of t!,e owner, and!hat plans submitted are in compliance with
34`11)65-PF3Ore on $W- ws.
t.cmc r Da
Electrical p, �YDWI�. ��'G !f %� /r�_
Sub- Mailing Address Co rlac Pers n ivamrj� - I �t
contractor � �wl t�.
City/state ZIP Phone _
Prior to,rermit
issuance a copy �"�il9yrp 6P ?7 FOR OFFICE USE ONLY;
of all licenses are Oregon Cons Cant.Boar+ Ex Dale
required if Lic.# p/ - f Plat#y Ma RL#.
expired in COT p
database Electtrriic_al�Licc..I/ Exp Dale—e S$tbacks: Zone: l O Solar:1
ticclric11 Supervisor Lie.# EOxp.0 e EEnngAl eering Approval: Planning c'Approve 114 r`1
__.28775 d i DI
�� 1:ldslsllormsWaddalLdoc 11/20/98
sni9icsewerage SANa8 AMI"= Ll [j, — ir,
agency f155155 SURFACE WATER
N. First Ave., Suite 270, Hillsboro, Or.,97124
503 648-8621
CONNECTION F'f.Ft'ill'
I C56UF: DATE 050599 EXP IRAT ION SATE 1.10199 FC E:XF' bA'f E 050401 PERMI r I. 1<5; 6
STRUCTURE ALDRE'SS 12847 PF5'OJ;; C;",' 4713
STRUCTURE STREET SW KAMEYt"ON WAY
L.OT 9 E I-OCK
f YF'E CONNECTION- NEW OF SCHOLL.S MEAI:ICIW+ GIJH:CtJVISICI J
I YPE: INSTAL.L.ATION- ( 19) HI U SWRiE'RO CON/SDC
TYPE. OC:CUI'ANCY- ( t ) SINSI E FAM'f.t. Y PARCEL, 2SIW1 AD 04,300
PTR SE11 4314 MH 2',, 56
OWNER ESI. INGE.R 0.1LI)E:RS 1N
ADDRESS 1,5036 SW LIPPER 'FtppNES FERR TRFATMF'.NT PI..AN1' I:ILIF.HAM
t.AKE 03WE.`;0 OR 97035
PHONE 5?lB--R655 WATER VI TRYCT T;(yARrt
.t.XTURE EQUIVAL-ENT DWE IA. ING RF9IrIFNTJ,)I- ^
`INITS SERVTCE: UNIT'S 0. 0 UNITS 1 ;FRV10E= UNITS 1
CONNECTION FEES SURFACE WATER DF`.VF"L..OPMP NT FF E'S
4:+C.WrF: CONNLCTION 12300 .00 W(IT FIR CiUA1_1TY 210.00
L-ESS CRFV1T ?10 ,00 >
WATER QUANTITY 290.00
LESS CREDIT 0.00':-
EROSION
0':-EROSION CONTROL.
INSPECTION 64 .00
Pt.hh! CHECK. 41 4 60
SUPIOTAL 2300,00 131I.IFIT0rAt. 395.60
raTA1.. 2695.60
AF'FF't_ NAME: MAI..i.' IL1i I"i1. 1NOE;R PHONE
OFFILI-I'AT111N f'IWNt.f:'
I'll E:MARKS
*2'4 HOUR NOTICE FOR E:ROStON CONTRIOL INS;'F1' 1 TONS RFOUIREI.t
!F'k%Il•'k* hd 1,j n,1',t;G � 1. ; �i ! I f+'i i f'i.l i'f P t' 1 T I i;i t'I h r{ _F�4 41 >k>k>k>K t#�
Permit Conditions: The applicant agrees to co-notth all rules and regulations of the Unified Sewerage Agency,including those regarding erosion control.
A 24-hour notice is required for.:roslon cor',ol Inspeections, The inspection iogrjeat numbtir is RV '1444 When catling for an inspection,piemm refer to
thin permit,project and lot numbers.
1 he permit expires one hundred eighty 11801 days from the date of issuance The Agency does not guarani,..,the accuracy of the location of side sewer lateral.
7/93 Wti t'rE IiSA, BLUE - Accnuntinq, GPEEN - Insprct inn, YLI,1,nW - (11Pt n1 nt
1
INSPECT; D BY DATE
',ONTRACTQRJINSTALLFR
1 yp ()F PINE _.�._. DIAMETER OF PI PF
Inspector, please sketch below or attach the followini information;
1 Street & nearest cross street
? I.ocatien o' structure being served
i 3 Roue of service line from structure to property line where it
Connects to the service lateral . Include length & diameter
of service line, depth at the structurra y property ling,
dimensions referencing line to structure, property eines
and/or corners, etc.
I North arrow
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12-647 15W ;-CA,M CRO N WAY
LOTg SCROLLS MEADOWS
WASHINGTON COUNTY
MAP 2525'hD-05500 ACT NO R2069197
ZONING R-25
12847 SW KAMERON WAY
TIGARD, OR
ESLINGER BUILDERS, INC. ( 598-8655 )
15836 SW Upper bones Ferry Rd.
Lake Oswego, OR 0035
EROSION CONTROL PLAN
1 . Silt fence to be installed at low side of lot
Driveways & sidewalks to be graveled
CITY' OF TIGARD CERTIFICATE OF OCCU'ANCY_
PERMIT#: MST99-OC 104
DEVELOPMENT SERVICES DATE ISSUED: 06/01/1999
13125 SW Hall I i.,Tigard, OR 97223 1503) 639-4171 PARCEL: 2S105AD-04300
ZONING: R-25
JURISDICTION: URB
SITE ADDRESS: 12857 SW KAMERON ✓VAYFILE
It
SUBDIVISION: SCHOLLS MEADOWS ��C
BLOCK: LOT:009
CLASS OF WORK: NEW
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: PATH I' New single family dwelling w/attached garage.
Final Building Inspection and Certificate of Occupancy
Approved 1/18/00 by Ken Schriendl, Building Inspector
Owner:
ESLINGER BUILDERS INC
15836 SW UPPER BOONES FERRY RO
LAKE OSWEGO, OR 97035
Phone: 598-8655
Contractor:
ESLINGER BUI!DERS INC
15836 SW UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035
Phone: 598-8655
Reg #:
This Certificate grants occupancy of 4he above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use under which the referenced permit was
issued. 1-/'
BUILDING INSPECTOR BUILD) G OFFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 6:39-4171
BUP _
—__lute Requested_ d� AM+ PM _ BLD —
Location12. �J � � � Suite _ MEC
Contact Person Ph PLM
Contractor Ph SWR
DI Tenant/Owner — _ _ ELC _
Retaining Wall ELR
Footing Access:
Foundation �- I FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ---- --
Slab --__.--- --- SIT
Post& Beam `---
Ext Sheath/Shear
Int Sheath/Shear — -
Framing
----- --------------
Insulation
I Drywall Nailing
Firewall
Fire Sprinkle-
Fire Alarm
Susp'd Ceiling ---
Roof
Misc: -- - --- - -
PASS PART FAIL -- -- - --- - -- - __ ---- --_--..
PrMTNG
Post& Beam --
Under Slab
Top Out - ---- ---- - -
Water Service
Sanitary Sewer
Rain Drains
anal -
PASS PART FAIL
MECHANICAL
Post& Beam ---- — _ ----
Rough In
Gas Line
Smoke Dampers
Final
PASS_ PART FAIL
ELECTRICAL —- -
Service
Rough In —
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading — — -- �-
Sanitary Sewer
Storm Drain [ ]Re:nspectlon fee of$ required before next inspection. Pay at City Hall, X0125 SW Hall Blvd
Catch Basin [ )Please for reinspection RE: __— -_. [ ;Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewolk -t
Dae / /i Inspector nspecor
Other t — Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
S
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