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10505 SW NAEVE STREET IS 3AgVN MS SOS01 IL z c� 1050.4 SW NAEVE ST ELEVATION CERTIFICATION PER SECTION 71 U.I of the USPSC C� OF �GD 35 l 0.I of the OTFDSC OREGON THE UPSTREAM MANHOLE, RINI APPEARS TO BE ABOVE SOME OR ALL OF THE FIXTURE. SPILL RIMS IN THIS STRUCTURE. INFORMATION IS NEEDED ON THE ELEVATION DIFFERENCE FROM THE MANHOLE TO THE LOWEST FLOOR CONTAINING PLUMBING FIXTURES TO ESTABLISH THE NEED FOR A BACKWATER VALVE(S) AND TO DETERMINE WHICH FIXTURES NEED TO BE PROTECTED FROM BACKFLOW. OBTAIN AND SUBMIT WRITTEN DOCUMENTATION TO THE CITY OF TIGARD BUILDING DEPARTMENT WITH THE FOLLOWING INFORMATION: LOT NUMBER SUBDIVISION Ej^jd,S&11 _lQ�k ADDRESS _l OSy j Z'Q eVCol _ PERMIT# f� '� . S6 A TRANSIT SHOT ON(DATE) HAS VERIFIED WHAT THE FIRST ` UPS'T'REAM MANHOLE SPILLRIM IS Q1 _HIGHER 00L CIRCLE ONE)THAN THE LOWEST FLOOR FINISH ELEVATION. `Z, b . -DATE. -7 - 31 -01 a PLUMBER H DATE JOB SUPERINTENDANT m C7 w J ABOVE INFORMATION ACCEPTED AND APPROVED BY: INSPECTOR DATE, L �/ 13125 SW Holl Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 ---- .-- CITY OF-TIGARD B DING INSPECTION DIVISIOO MST „Zvy( ayZS ' 24-Hour Inspection Line: 6 175 Business Line: 639-4171 BUP _ Date Requested - _AM PM — BLD Location_ / D C:>S � G �_ Suite _ MEC Contact Person Ph _ ` D Z PLM — Contractor Ph SWR BUILDING Tenant/Owner _ _ ELC Retaining Wall — ELR Footing Access:Foundation FPS Ftg Drain C7rawl Drain Inspection dotes: SGN --� Slab SIT Post&Beam -'� Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation — — -- Drywall Nailing Firewall -- Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: Final PASS PART FAIL —._— LUMBIN - PosBeam ----- Unde.. Slab Top Out - -- - — ----- Water Service _ Sanitary Sewer -- Raiii Qrains _-- Fi — — SS PART FAIL ANICAL Post tl,Beam — Rough In Gas Line --- — -- _ Smoke Dampers Final - -- - -- - PA FAIL C ICAL — —�— —_--� — — IL Service Rough In UG/Slab LowVoltage Fire — Fire Alarm J i _m A PART FAIL _ _- 0 J Backfill/Greiding - - — — Sanitary Sewer Storm Drain ( J RelrisPection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE: __— [ J Unable to inspect-no access ADA 1 OtheoachlSidewalk Date ,, J / Inspector E xt Final PASS PART FAIL DO NOT REMWE this Inspectlon record from the job site. sle . AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA � i i iv i t � Wo ► 4 pop. i , loo.a I■■� o ° ` o ► ► `o ; q q ► i ° s V-1 ► i ° o ► ► v Q i o b ► a J a, i FMO i i Q w i CITY OF 7iGARD BUILDING INSPECTION DIVISION MSTeZG?0( 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 SUP _—Date Requested f d.- 1 -7 AM PM BLD Location_ 0 5 O j D:)Q Suite MEC Contact Person " t�-e. Ph _Y�/l 3/O Z- PLM _ Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: — — Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN __— Slab Post& Beam --- ---- SIT — Ext Sheath/Shear Int Sheath/Shear Framing Insulation — -- --- Drywall Nailing Firewall — — --- - Fire Sprinkler Fire Alarm -- ---- — --- Susp'd Ceiling Roof _ ----- ---- Mis :`1=� — RT FAIL PLUMBING Post&Beam - Under Slab Top Cut _.— - --- ----- -- --- - Water Semite Sanitary Sewer -- — — —----- Rain Drains Final PASS PART FAIL — — — MECHANICAL Pnst&Beam Rough In Gas Line - -- -- -- -- Smoke Dampers Final ---- _ — PASS PART FAIL ELECTRICAL — ---- -— — n. Servii;e Rough In — t~17 UG/Slab _ Low Voltage Fire Alarm .t Final ----------- �. �_ — - — - m PASS PART FAIL SITE -'t Backfill/Grading -- -- Sanitary Sewer Storm Drain [ ]Reinspection fee of _ —_ required before next inspection. Pay at City Hall, 13126 SW Hall Blvd Catch Basir Fire Supply Line [ )Please call for reinspection RE: 7' [ ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date z-D/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. ..,...a......... ...,......., i. •sr:a:�,.,n.,4.yww4.„sJq��,'�Yi1�i111rYil„ oa C d \' O v � I � C t1, C O y n J 6 N 0 Cho N W6 u u V II � � 1 "rzs In 'b D. •,� � o a w y q t U o0 c w 7 U c CITY OF TIGARD PLUMBING PERMIT _ DEVELOPMENT SERVICES PERMIT#: PLM2001-00519 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 DATE ISSUED: 10/11/01 SITE ADDRESS: 10505 SW NAEVE ST PARCEL: 2S110DA-06000 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 021 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE !TOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRiEVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WAT ER HEATERS: CATCH BASINS: FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: _ URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS, RAIN nruUN. ft Remarks: Installation of back flow preventer for sprinklerr next^o motor_ FEES Owner: -�— Tyl+e � By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 10/11/01 $36.25 27200100000y 1672 SW WILLAMETTE FALLS DR 5PCT CTR 10/11/01 $2.90 27200100000 WEST LINN, OR 97068 ----- Total $39.15 Phone 1: 503-557-8000 Contractor: TRADEMARK LANDSCAPES, INC. 18478W WALKER RD. OREGON CITY, OR 97045 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 503-631-3890 Final Inspection Reg#: PLM 6796 a oc I— This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Special'v Codes and all other applicable laws. All work will be done in accordance with approved plans. JThis pc ' will expire if work is not started within 180 days of issuance, or if work is suspended for more than 18 -s ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notificah ,., ,;enter. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-1987. Issued By. �', ti - �,/,(,C� , Permittee Signature: Call(503)639-4175 by 7:00 P.M.for an Inspection needed the next business day Plumbing Permit Appli 'on Datereceived: / /! Permit no.. City Of Tigar J Sewer permit no.: Building g permit no.: Address: 13125 SW Hall Blvd,Tigard, R 97 C"irvofTigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: LI 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement *ew construction U Ad(iition/alteration/replacement U Food service U Other: Job address: LOSCS 'S.W. NC E13E VT . Description R!y. Fee ea.) Total Bldg.no.: Suite no.: New -and 2-family dwellings only: Tax map/tax lot/r-r-lint no.: '— (lnchdes I00ft.for catch utilhycor iedloe) SFR(1)bath _ Lot: 2- 1 Block: Subdivision: SFR(2)bath _Pmiect name: ERtCK5&q (4E! 7'S SFR(3)bath City/county: JA)e5tj I ZIP: 9-722:3 Each additional bath/kitchen Description and location of work on premises: _Ola SNeotWfka: r S ff'trikk✓3 h t f.f tc, yvtQ}cr Catch basin/arra drain Est.date of completion/inspection: Ip_1'Z-2A41 I Drywells/leach!ine/trench drain Footin drain(no. lin.ft.) Manufactured home utilities Business name: pEvvt►licte Li4NOiSxJfPY"T/•tC Manhoera Address: Rain drain connecter — — City: ()rcq o n C State:p,� ZIP oyS Sanita sewer(no.lin.ft.) -- Phone:Sc'J-631-*G Fax:631-q-731 E-mail: Storm sewer(no.lin.ft.) CCB no.: 6196 Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: C)W()GZ03 Fixture or trent: tion valve Contractor's representative signature: Abso T Back flow reventer Print name: STL J E I,L( 1 S Date: i p-/I <w► Backwater valve _ Basins/lavatory 1 Name: S'T C_V t`t_t_I S Clothes washer t Address: Dishwasher S� — City: _ _ State:__ ZIP: Drinking fountain(s) _ Ejectors/sump Phone: $oy-2o13 Fax: mail: Expansion tank Mixturelsewer cap — Name(print): Qcriatnnottv�`or,'f Floor drains/floor sinks/hub address_Lel Z _ �� , Garbage disposal Mailin g W�l 1E=,"►t-�t rHose bibb City: WEST LI NN State:c 4,e Z'P: 7766T Ice maker Phone: $57- Fax: 'F snail: Interco or/ reae trap Owner instal lalion/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(comrr--reial) ✓) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), ays(s) Owner's signature: _ Date: Sump - Tu�91 �_ /shower pan Name: U Address: -- W -t City: State: ZIP: Water heater Othrr: Phone: Fax: E-mail: Tow Noi all huiadkdo ns wcW credit cards.please call jurisdiction fox more information. Minimum fee................$ U viexpires it's permit sa U MasterCard Notice:This permpermit i appli rationsnot obtained Plan review(at %) S -- Credit cad mrmber: _._ � � within 180 days after it has been State surcharge(8%) ....$ r spire' TOTAL .......................------ ecce ted as com tete. S Name or cnrdhnlofer as shown on credit cad P P ---- _ S Cardholder siguture --- —AtmaM dM)Ifi16(6OOK OM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES Ondividual__ - QTY ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection -_ One 1 bath _ $2.49.20 Tub or Tub/Shower Com) 16.60 _ Two 2 bath _ - $350.00 Shower Only 18.60 - Three 3 bath 1399.00 W ter Closet - _ 16.60 - SUBTOTAL Uri I 16.60 no STATE 8JACHARGE Dish sher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ Garbag Disposal 16.60 �- -__ TOTAL - Laundry TN 16.60 Washing Mac a 16.60 Floor UralWFloor k 2" 16.60 ," - ,-r;.60 PLEAS COMPLETE: 16.80 Water Heater O conversion 0,4ke kind 16.60 Quantity Work Performed Gas piping requires a separate mec ical FixtureT New Moved Replaced Removed/ permit. -__ _ Capped MFG Home New Water Service 46.41? Sink _ MFC Home New San/St�rrn Sewer 46.40 Lavat Hose Bibs 1660 Tub r Tub/Shower _-_ Cc binatlon - Roof Drains 16. S46wer Only Drinking Fountain 16.60 ater Closet Other Fixtures(Specify) 16.60 -' Anal - - ishwasher Garbage Deposal Laundry Room Tray - - \Washing Machine Sewer-1st 100' 55.00 r Draln/Sink: 2"3" Sewer-each additional 100' 46.40 - 4" �- Water Service-let 100' 55.00 Water He r Water Service-each additional 200' 46.80 Other Fixture (Specify) Storm 4 Rain Drain-1st 100' 55.00 Storm d Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 -- - Residential Backflow Prevention Device' 27.65 - -- Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 -Requested Ins ectiors mr/hr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 Grease Traps 16.60 _-- QUANTITY TOTAL ----' - Isometric or riser diagram Is required If ----- - G _ Guantlty Total Is >9 -- LY 'SUBTOTAL - ---- --- - fn 8%STATE SURCHARGE .:1 "PLAN REVIEW 25%OF SUBTOTAL m Required orgy If fixture qty.total Is>0 � TOTAL � W J *Minimum permit fee Is$72 50+8%stale surcharge,exrW ReskiervIN AackBow Prevention Oevlce,which is S•36 25•8%state surcharge "ATI New commercial Buildings requlrs 2 soft of plans wlfh Isometric or Oser diagram for plan ravlew. i:%d9ts\forms\plm-fees.doc 06/29/01 CITY OF TIGARD 13126 S.W. HALL BLVD. RECEIVED TIGARD, OR 97223 MAY IMPORTANT PERMIT NOTICE CQM ITY D�FVF'LOPMFNI GAGE ENTERPRISES a S S INC PO BOX 1429 ] CLACKAMAS, OR 97016-1429 Electrical Signature Form Permit#: MST2001-00258 Date Issued: 5/15/01 Parcel: 2S110DA-06000 Site Address: 10505 SW NAEVE ST Subdivision: ERICKSON HEIGHTS Block: Lot: 021 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence.S/F Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work 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 1673 SW WILLAMETTE FALLS DR PO BOX 1429 WEST LINN, OR 97068 CLACKAMAS, OR 97015-1429 Phone #: 503-557-8000 Phone #: 503-657-0142 Req #: UP 8188 LIC 348" IL ELE 3-128 Ix r- AN INK SIGNATURE IS REQUIRED ON THIS FORM U X ?-____ Signature of Super,ising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY O F T I G A R D MASTER PERMIT PERMIT ad: ;,iST2001-00258 DEVELOPMENT SERVICES DATE ISSUED: 5/15/01 13125 SW Hail Blvd.,Tigard,OR 97223 (503)6394171 SITE ADDRESS: 10505 SW NAEVE ST PARCEL: 2S110DA-00000 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LUT:021 JURISDICTION: TIG REMARKS: Construction of new single family detached residence.S/F"Path 1 BUILDING REISSUE: STORIES. 2 FLOOR AREAS REQUIRED SF.TBA/;Ka REQUIRED .--- CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,447 of BASEMENT: of LEFT: 7 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOADS 40 SECOND: 1,583 of GAkAGE: 670 of FRONT: 20 PARKING SPACES: 2 TYPE.OF CONST: 5N DWELLING UNrrs: 1 FINSSMENT: of RIGHT: 7 OCCUPANCY GRP: R3 BORM: 3 BATH: 3 TOTAL: 3,030VALUE: 3 261,374.60,00 of RJ1R: 73 _ PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAY!: 1 ^�RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBAHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1GO BCKFLW PREVNTR: 1 GREASk,TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN�100X: BOIL/CMP t 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>s100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCE:'• VENTS. 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT, SERVICE FEEDER TEVP ERVC/FEEDERS BRANCH CIRCUITS WSCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - RUO trop: 0 200 amp WlSVC OR FOR: 1 PUMPORRIGATtON: PER INSPECTfON: EA ADD'L 500SF: 8 201 -400 amp: 201 400 amp: lot W/O SVC.'FDR: ir0 SIGNIOUT LIN LT. PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 600 omp: EA ADDI BR C!R: SIONALMANEL: IN PLANT: MANU HM/SVC/FDR: 601 , 1900 amp: 401+8nl00-1000v: MINOR LABEL: 1000+ampNoh Reconnect only: -- PLAN REVIEW SECTION --- ---- >.4 RES UNITS: SWIFOR-225 A.: >000 V NOMINAL: CLS ARrA/SPC OCC: _ EL_ECTRICAL•RESTRICTED ENERGY___ A.SF RESIDENTIAL _ B.COMMERCIAL�� _ AUDIO S STEREO: X VACUUM SYSTEM: X AUDIO A STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL ENCOM BOILER: HVAC: LANDSCAPERRRIG: PROTECTIVE SIGNL GARAGE OPENER: X CLOCK: INSTRUMENTATION, MEOISAL: OTHR: HVAC: X DATArrFLE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,139.23 This permit Is subject to the regulations contained in the RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Munk ipal Code,State of 0F7. Specialty Codes and 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTF FALLS DR WEST LINN,OR 97068 WEST LINN,OR 97068 all other applicable laws. AI'work Will be done in accordance with appmvmd plans. This permitwell expire if IL work Is not started within 180 days of Issuance,or if the work is suspended for more than 130 days. ATTENTION: R Phone: Phone: Oregon law requires you to follow rules adopted by the N Oregon Utility Notification Center. Thom rules am set Rog N: 1 IC 049955 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or dimct questlons to OUNC by calling(503)246-1987 � REQUIRED INSPECTIONS W Erosion Control Insp 8, Post/Beam Mtchanicai Mechanical Insp Shear Wall Insp Insulation Insp Me&.inical Final Sewer!nsperhon Underfloor insulation Plumb Top Out Exterior Sheathing Ins{ Rain drain Insp Plumb Final Footing Insp Crawl Drain(Backwater Electrical Sevloe Low Voltage Water Line IIIsp Final inspection Foundation Insp Footing/Foundation Dr; Electr,cal Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final ...��.waa► Issued By Permittee Signature Call(503)639-4175 by 7:00 p.m.for at1 inspection needed the next business day 21,A CITY OF TIGARD SEWER CONNECTION PERMIT 16 DEVELOPMENT SERVICES PERMIT 0: SWR2001-00157 13125 SW Hall Blvd.,Tigard,OR 95223 (503) 6394171 DATE ISSUED: 5/15/01 SITE ADDRESS; 10505 SW NAEVE ST PARCEL: 2S110DA-06000 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 021 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: L.TPSWR IMPERV SURFACE: Remarks: Sewer connection for new single family residence. Owner: --i'— --- -- FEES RENAISSANCE CUSTOM HOMES Type By Date^ Amount Receipt 1672 SW WILLAMET-TE FALLS OR WEST LINN, OR 97068 PRMT CTR 6/15/01 $2,300A0 27200100000 INSP CTR 5/15/01 $35.00 27200100000 Phone: 503-557-8000 Total $2,335.00 Contractor: Phone: Reg#: Require Irs ections a ac :n m This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires W180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agenry does not -� guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503; 246-1987. V1 Issued byLli � Permittee Signature: Call(503)539.4178 by 7.00 P.M.for an Inspection needed the ext business day Y�tuldifigAe"i'rrmi't P3' �(V sosol dW� o�-oo�s P City of Tigard 'ermitno.: CiryojTigurd Address: 13125 SW Hall Blvd,Tigard,OR ixpiredate: Phone; (503) 639-4171 Date issued: Fax: (503) 598-1960 By:: Receiptno.: Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: t 2 family dwelling or accessory ❑Commercial/industrial 1 J Multi-family 6U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm ❑Odier: ❑ Demolition W-lif 10 7171=1 Job address: hj T Lot: 'j1 Block: Subdivision: Bldg.no.: Suite no.: Tax map/tax lot/account no.;�1� 17�4_04eVo Project name: _ � O v Description and location of work on premises/special conditions: _ R� 155AW Name: � w '��,� Mailing address: City: L Stat at l &2 family dwelth Phone: _ ZIP: �p Valuation x of tvork....p��r�' ..J Fa L-mail: No.of bedrootns/baths............ — Owner's reprosentatie:: ••••••••••••••••••••• 1 Z.t O1 - Fa � Total number of floors Z Phone: ............................... .$(/�j E-mail: New dwelling area(sq R•) ..+,�(1. .Q....... Zip FAWWR 1A Name: Garage/carport area(aq.ft.) ........................ - I Covered porch area(sq.ft.) Mailing address• Deck area(sq.ft.) City: State: ZIP: Other structure area(sq. R. Phone: I ax: E-mail: CommercinUindustriaurnulti-family: tLl I LfA ViValuation of work........................................ S I Business name: Existing bldg.area(sq.ft.) .................. Address: -- New bldg.area(sq.ft.) ............ . .. -- ........... City: State: ZIP: Number of stories.................... .. ............ Phone: Fax: E-mail: Type of construction................. ........ ........ CCB no.: - - Occupancy group(s): Existing: _ City/metro tic.no. -- New: t Notice:All contractors and subcontractors are required to be Name. POLLAW1 licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Address: �� "--- jurisdiction where work is being performed. If the applicant is IL Cit Stale:— ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: Phone.&2A-/t Z 1 Fax mail:W kAV.Pfd V, -- Name: Ct ' mJ Contact person: h R. Fees due upon application ........................... $_ Address: Z Date received: �ry City: N State: ZIP: W Phone: °1120 Amount received ......................................... S —t F�QTe 0 1 E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and theNat sll juriurictlone axePt credit cwm.please cd)jurisdiction rer mere inrorn alion attached checklist.All provisions of laws and ordinances governing this o vis. o Mastercard work will be complied whether specified herein or nol. etdit erd number. Authorized signature: Date•011LV "Pito Namrz or cer ardholdas rhewn en credit Bard el Print name: s Notice:This perm;i application expire:if a permit is not obtained widiin 180 days after it hes been accepted as complete. •aAmount o-4613 ttwovc-•ohq Electrical Perndt Application City Of Tigard Gate received: Permit no.: Pro ect/a 1.no.:Address: 13125 SW Hall Blvd Tigard, pp Expiredate: CiryofTigard g ,OR 97223 Phone: (503) 6394171 Date issued: By: Receiptno.: Fax: (503) 598-1960 (:ase fill.no. Payment type: Land use approval: 1 &2 family dwelling or accessory Cl CommerciaUi.ndustriol U Multi-famil ew construction y U renant improvement U Addition/alteration/replacement U Other: _ U Partial tl 1 1 Job address: Suite no.: ITax map/tax lot/account no.: Lot: Block: Subdivision: E1t,t4ks (� Prujeci name: _ I Description and location of work on pttimises: --- Estimated elate of conipletion/inspection: Job no: - Fir MAX BUSiness name: Description _ Qty. (ea.) Total no.urs Address: P New rrsidential-single or milli-family per Clfy: G �_ dwelling unit_Includes attachrtlpmge. State:m ZIService included: Phone: Z F .�3 E-mail: 1000 sq,ft.or less 4 CCB n0.: Q Elec.bus,lic n0: Fach additional 500 sq.f— t.o�on Iltaeof City/metro lic. no.: limited energy,residential 2 Limited energy,non-tesidential _ _ Each manufactured home or modulardwelling 2 Signature of su ervising electrician(required-)_ Date Service and/or feeder 1 Sup.titer.name(primp enol wr Senlcesorfeedets-htstalle8aa, PROPERTY OWNER sitess(ion or relocation: 200 amps or leas 2 L Name(print): 6VV a S 201 amps to 403 amps 2 Mailing address: L 401 amps to 600 amps 2 City: W ��N^ State:QK, ZIP: a 601 amps to IOOO amps ry 2 (0 Over 1000 amps or Valu 2 Phan. f a E-mail: Reconnectonly Owner installation:The it,srallation is being made on property I own Itmporaryservicesorfeeders- t which is not intended fo sa L, lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,6 I, 200 snips or less Owner's signature: _ �--� Date 7 I 201 amps to 4110 amps `� 2 --- 401 to(90 am 2 Note]1011 1� Branch circuits-rew,slterntion, Name: G6A or extension per panel: Address: 3'L _ � / A. Fee for hranch circuits with purchase of City: ^ 0411 -service or feeder fee,each branch circuit 2 V Slate ZIP: -1 Z L B. Fee for branch circuits without purchase PhrI, 1.;t. C1 1 E-mail: of service or feeder fee,first branch circuit: 2 4, 301111114 [MIMIEsch additiousl branch circuit. Mise.(Srrrllx or feed er tat Included); U Se"/1(:cOver 225 amps-commercial U Hedrh-cue facility I I I Each pump or irrigation circle N 0 Service over 320 amps-toting or 1142 0 Hazardous location Each sign or_outline lighting 2 fantilydwellings O Building over 10,000 square feet fnur or Signnl circuits)or a littuted tragi 2 E O System over600volts nominal gypanel, - more residential units in one structure alteration,orextension• J U Building overthree stories 0 Feelers,400 amps or more 2 0 Occupant load over 99 persons U Manufactured structures or RV park •1'-escripdan: O Egrcas/lighting plan 0 Other:._ inch additional hspectton over the allowable in any o: sbore; UJSubmit_sets of plans with any of the above, u! •' inspection The above are not applicable to temporary construction se; Investigation fee _- __ Other Nut alt jutisdi wit accept credit cards,please call jurisdiction for mar info- on, Notie This permit application Peanut fee.....................S O Visa O MustetCard Plan review expires if a permit is not obtained (at ._ Credit cud number:_ � � ) e-- 1P re`: within ISO days after it has been State surcharge(8%)....Z Name of eurdhelder u shown on creh't cirri accepted as complete. TOTAL .......................f $ Cardholder signature Amount 4/04615(GuwoM) Ylumbi-ng Permit Application .� e,Ity of Tigard Date received: 5 �/ Permitno.: Address: 13125 SW Hall Blvd,Tigard,OR 97123 Sewer permit no.: ild uin R Ciryr�/Tigard phone: (503)639-4171 --�.� gpermit no,: Fax: (503) 598-1960 Projecdappl.nn.: Expire date: Date,issued: --- Land use approval: 6y: Receipt no.: Case file no.: Payment type: &2 family dwelling or accessory U CununrrciaUindustrial ew consttuctton (.7 Addition alteration/re lacement OMulti-family Ll Tenant improvement P O Food servic, ❑Other: Job address: LL �.�. t Bldg. no.: �7W —� —�-•— Description Suite no.: New I-and 2-Paarily dwellutgs ottir Qt l ec �') Total Tax map/tax lot/account no.: (includes 100 R.for each utility connection) Lor. Block: Subdivision: — SFR(I)bath Project name: p SFR(2)bath City/county: SFR(3)bath - ZIP' 'f, Each additional bath/kitchen Description and location of work on premises:_ 4.M S'i?L Site utilities: Est,date of completion/inspection: �--— Catch basin/area drain Drywells/Icach Iineltrench drainLWAAMIll _-- t Footing drain(no.lin. -- Business name: w Manufactured home utilities Address: I (ot,—e�w Manholes City: State: Rain drain connector Phone: ZIP: q'r Sanitary sewer(no,lin.ft J - -- F E-mail: Storm sewer(no.lin.ft.) CCB no.: 'j 41(o" Plumb.bus.reg,no: 60_14,tt f Water service(no. lin.ft.) City/metro lic.no.: fixture or item: Contractor's representative signature: _ Absorption valve Print name. D nate: Sack Oow preventer t t Backwater valve Ne' Q�. �-iL Basinsllavatory - Clothes washer - Dishwasher Ctty' State: /,Ih - _ Drinking fountains) . Phone - --�- F E_m�il Ejectors/sump t a, _E_xpansio� n tank --- - Fixturelsewer cap Name(print): R�N�► J G� Floor drains/floor sinks/hu�b Mailing address: JAL_I Qarbage disposal City: NN StateZIP: Hose bibb Phone: Fa - Ice make. Owner instal lation/residential maintenance only: The actual installation Interceptor/gyrase trap R will be made by me or the maintenance and repair made by my regular Primer(s) H employee on the pro y 1 own as per URS Chapter 447. Roof drain(commen:ial) - Owner's signature: Si (s), asin(s), lays(s) Date:'&311 & Sum t Tubs/shower/showerat-'i Name: �L� Urinal r Address:�j1T f - — Water closet City: Np — — — 2v wtc�' r heater Phon Stater" ZIP: 1 Fa. Email. r Total er. _ Not VI jurtadietiom accept credit nude,please cell Jurisdiction for more information.O Visa Q MasterCard Notice.71tis permit application Minimum fee................$ Credit card number. / / expires ifs permit Is not obtained Plan review(tit _ %) $ -- "ptrre within 90 days after it has been State surcharge(8%) ....$ Name of cadholder awahon ereAit ad $ accepted as complete. Tod ' Cardholder signature Amaanr 440-4616(MXA oM) Mechanical Permit Application Datereceived: 51,/0', PermiIno.: 4jgQ7 -00 5 City of Tigard PmjecUappt noFatpitedate: City of Tigard Address; 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ _ [:Building Permit no TTPE OF �1 &2 family dwelling or accessory ❑Commercial./industrial U Multi-fancily 0 Tenmtt improvement XNew construction ❑Addition/alteratiort/replacentent U Other. _ _ 11 1 t t -- Job address: N EYE '�j_T_ Indicate equipment quantities in boxes below.Indicate the dollar Bldg. no.: Suite no.. value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ _ Lot: dL I I Block: Subdivision:FjL _(J 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: )" ZIR. 2 fSCHEDULE Description and location of work on premises: I t I 1 t Ftx(ra.) 'Total Est.date of completion/inspection: -Description qty. Res.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned?❑Yes U No Air handling unit CFM -- Airconditionmg(siteplanrequire Is existing space insulatc(19 U Yes U No Alteration of existing 11VAC system MECHANICAL CONTRACTOR of er compressors Business name: G t "nN� State boiler permit no.: Address HP Tons BTU/142�'�p �j E 3� _ Fir smo•e dampers/duct smo•e etectors City: WI—W?WWState:-M Z Hent pump(site plan required) ri ed) Phon 0- Z, I Fax: E-mail: Instal replace furnace/burner CCB no.: D Including duetwork/vent liner U Yes O No ImtalVreplac relocate heaters--suspended, City/metro tic. no.: - wall,or floor mounted Name(please print): Vent for appliance other than furnace t tRefrigeration: Absorption units-,_ _ ATU/tl Nance: ��E (1 Chillers_ --__ HP Address: -Compressors HP Environmentalexhaust an ventilation: City: state: ZIP: _ Appliancevent Phone. hax: - E mail: ryerexhaust — 0o s,Type V Wres. kitchen/hazmat .�� hood fire suppression system ��Name: _.1�✓��IL�L.tG Exhaust fan with single duct(bath fans) 4 Mailing address: _ 5 x taust system apart from heating or A City: ( N State III': 611,D&45Fuelpiping an sl cul on up to outlets) F- Type: LPG _ NG Oil Phort �. Fa. i;-nutiL vel pspin each a diuonal over 4 outlets_ — we-ss piping(schematic required) Name: Numberofoutleis 1 ter islet appliance o�oqt Tip `- m Address: L� w _ �- Decorative fireplace (9 City; ftll-A� State: 'ZIP: &I I v Insert-type -- W Phon , Email _ Woodstov pe etstove Applicant's signature: Date: cher.� � Other: - Name (print): fMFH f?M - - -- -- Na all juricdictinns¢cep credit code,plena cell junediction ror more inrannation. Permit fee.....................$ O visa U MasterCard otice:This permit application Minimum fee................$ Credit card number: expires if a pemtit is not obtained - E,p�-- within 1 RO days atter it has been Plan review(at _ 96) $ Name of cardholder ar shown on credit cud accepted 0 TOTAL .......................$ complete. State surcharge(. 1b)....$ t Cardholder sitnamte Atrtoant - 440-4617(6MCOM) N89'45'10" E J 142.86 'J .00 off U1 "� - -- -- IL IL .t (Ytl w p i. - �--- - ( co W � `� /^ °°'"c TS, OS'fV/ M .00" t � Raw m ' 14 - 73.0' -- ---- O OS'8 65 O _ c LIJ U 20.0' 0 .09'0z g tr s � '00's - 10 S 89'4510" W 139.01' m � ' �tM�NIM?t1M1�1 N aNva�a ori UMXpwVWW Z ul I WAM11RACL AWAN ia;1�11 OC H m SCALE DRA WING LOT 21, ERICKSON HEIGHTS w S.E. 114 SEC. 10, T.2S., R.1W., W.M. NA�V� i05O5 W �T- --A 2.5 FOOT PUBLIC LANDSCAPE EASEMENT CITY OF TIGARD SHALL EXIST ALONG ALL STREET FRONTAGE WASHINGTON COUNTY, OREGON I I --A 7.5 FOOT PUBLIC UTILITY EASEMENT SHALL EXIST ALONG THE LANDSCAPE EASEMENT .� APRIL 25, 2001 C, r t c r I i n c Con c e p t s I n c. DRAWN BY: MPW CHECKED BY: WGDI11 115 EMAIL WWW-CCIVMAILWDA0L.00M SCALE 1"=20' ACCOUNT 640 82nd Drive Gladstone, Oregon 97027 M: MLI L21ERICK 503 650-0188 fax 503 650-0189 CITY OF TIGARD 13126 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED MAY N s 200 IMPORTANT PERMIT NOTICE COMMUNITY OFVF.LOPMENI CRAFTWORK PL s!MBING INC nn S y 7736 SW NIMBUS AVE BEAVERTON, OR 97008 Plumbing Signatures Form Permit #: MST2001-00258 Date Issued: 5/15/01 Parcel: 2S110DA-06000 Site Address: 10505 SW NAEVE ST Subdivision: ERICKSON HEIGHTS Block: Lot: 021 jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence.S/F 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 BEAVE►RTON, OR 97008 Phone M 503-557-8000 Phone M 644-8698 Reg #: LIC 79666 o. PI M 20-148PB Lr H AN INK SIGNATURE IS REQUIRED ON THIS FORM m W X J Signature of Authorized Plumber If you have any questions, please call (503)639-4171, ext. # 310