11792 SW TALLWOOD DRIVE ADDRESS:
1 -19 Q, aZ To,��WQCA 5�)t, \,I
i:\records\microfim\targets\auilding.doc
ICATE 07
OCCUPANY
CITY OF TIGARD PERMI)cERTIF#. . . . . . . .CMST95 -0106
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/30/95
13125 SW Hall Blvd.Tigard,Orogon 97223o$199 (50?)639-4171
117912 SW TALLWOOD DR PARCEL: IS133CD-12900
SUBDIVISION. . . . : PEDDLECREER ZONING:R--85
BLOCK. . . . . . . . . . : L(31... . . . . . . . . . . . . :022
OF W01"'K, cNEW
r vpE OF USS:. . . kc
OCCUPANCY 6;,P. :5N
OCCUPANCY LOADo2
Rem-lrkst PATH I
COSTA PACIFIC HOME-S3
062!:- f.M CASCADE
f*606
fNEAVLr,'r0N OR 97005
Phor-.: #r 5121,! -646 -8888
('USTA -r-'ACIFIC HOW-7r,
6625 sw CASCADE AVE STE. 6121(1
1"AEAVERTON OR 9/005
'hons�, #s 1-503-646 A3888
)09 63157
his Cvrtiftrate gr-ants OCCLIPIMCY of the above t-eferevicecl building or pot-'tios)
illereof ;,*n(J confirms that the building been insperted for compllanca witl
f,he Statp of Ot,egon [;pecialty rodvf4 ff.)v, the -%
, qt (-
Ltpi occupancy, and tvie uride,�
'4hicli the ref ed permit was iSSUL%d.
r
,0171 ")ING INSPECTOR ICU 11-A)ING WrICIAl_
POST IN t.ONSPICUOUS PL.A(,',E
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone) 639-4175 Business Phone: 639.4171
�1
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Fiog, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg Top Out Elec. Rough-in FINAL- '
Post/Beam Mech. Sari, Sewer Gas I.ine C@lS1GTJ✓ �j
Plbg Underiloor Rain Drain Framing Plumb,�Or " 1
Alarm Water Line .ulation Mech,Undertlr. InSLJ. Shear Wall Gyp. Bd. Elect Oil
Date Requested: ( . e� _.Time: AM PM
/ I _7 �
Address: �– � ��C ��!//\
P-ilder, Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
L
oe
i s ector:
PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
i� —Call For Reinsp.
r
h
-LIMMUM I
TO: NEW PROPERTY OWNER
FROM: DAVID SCOTT, BUILDING OFFICIAL
Attached is a memo gyve received from our Engineering Department. Although no inspection
was requested prior to the placement of concrete in your sidewalk and driveway approach, or a
reinspection was not requested after an initial dissapproved inspection, the Engineering
Department Indicates that the constniction appears satisfactory by observation.
The Engincering Department recomme�-ied that we notify you of this. Please refer to the
attached memo for more detail.
Please call Jeanine Flaig at 639-4171 ext. 310 if you have any questions.
I
loeinije,nr:'gdwik
CITY OF TIGARD
OREGON
MEMORANDUM /
CITY OF TIGARD, OREGON
TO: David Scott , Building Official
FROM: Michael Anderson, Engineering Depafcment
SUBJECT: Sidewalk Inspections
Letha Thomas, Inspector, has informed me that the sidewalk and
approach at the address of the attached file, was not inspected
prior to pour.
inasmuch as the future maintenance of ti sidewalk and approach is
the responsibility of the adjoining property owner, it is our
recommendation that the Building Department notify the property
owner that no inspection for this item was done and that any
problems within one year of the Certificate of Occupany should be
referred back to their builder. The construction appears
satisfactory by observation and no further work is recommender. at
this time .
^"125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 IDD (503) 634-2772
Page No. 1 CASE HISTORY FOR CASE. NO.: MST-5-0106
COSTA PACIFIC HOMES
11792 SW TALLWOOD DR
08/1x/98
Action Description Req/ Schd/ Eno/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
-------- -----------
MSTA007 Application received / / / / 03/09/95 PASS JD 03/10/95 BLT
MSTA010 Plan check deposit paid / / / / 03/09/95 PASS JD 03/10/95 BLT
META020 Plan check by 03/10/95 / / 03/10/95 PASS RT 03/10/95 BLT
MSTA030 Check for prcl. restrict. / / 03/10/95 03/09/95 PASS JD 03/10/95 BLT
MSTA092 (F) Issue combination permit / / / / 03/22/95 JF 03/22/95 JF
MSTA097 Issue plumbing signature form / / / / 03/22/95 JF 03/22/95 JF
MSTA795 Footing Insp / / / / 03/24/95 N-1- mpnolithic ftg/ fdn A/N KS 03/27/95 KBS
#-2- 14- fdn vents
MSTA706 Foundation Insp / / / / 03/24/95 A/N KS 03/30/95 KBS
MSTA71.0 Poet/Beam Structural / / / / 03/30/95 #-1- install either post or hangers at A/N KS 03/31/9`. KBS
interior bearing beams
MSTA711 Poet/Beam Mechanical / / / / 03/30/95 APP KS 03/30/95 KBS
MSTA717 PLM/Underfloor / / / / 03/29/95 PALS MS 03/30/95 MRS
MSTA720 Mechanical Insp / / / / 05/18/95 q 1 supp,rt bw vent at upper level 1 AIN KS 05/18/95 KBS
stud cavity)
4 2 provide protective barrier at b
vent att'.c
MSTA722 Plumb Top Out / / / / 05/09/95 PASS MS 05/10/95 MRS
MSIA725 Framing Insp / / / / 05/16/95 0 1 sr-e inspection notes DIS KS 05/17/95 KBS
MSTA726 Framing -REINSP> / / / / 05/18/95 APP KS 05/18/95 KBS
MSTA735 Gas Line Insp / / / / 05/11/95 # 1 17 psi for 15 minutes 11:1 support A/N KS 05/12/95 KBE
gas piping under fl
M53TA740 Insulation Insp / / / / 05/18/95 APP KS 05/18/95 KBS
MSTA745 Gvp Board Insp / / 1 ' 05/23/95 # I see inspection notes A/N KS 05/24/95 KBS
MSTA755 Rain drain Insp / / / / 03/28/95 PASS MS 03/29/95 MRS
ME A760 Water Line Insp / / / / 03/28/95 PASS MS 03/29/95 MRS
MSTA761 Water Service Insp / / / / 03/28/95 PASS MS 03/29/95 MRS
MJTA7L5 Appr/Sdwlk Insp / / / / 06/30/45 1) A.C. pavement replacem+nt required FAIL LT 07/27/95 NL
along approach. Sawcut required.
MSTA765 Appr/Sdwlk insp / / / / 07/21/95 'AIL LT 07/27/95 NL
MSTA765 Appr/Sdwlk Insp / / / / 07/21/95 1) Sawcut damaged areas in front of FAIL LT 12/27/95 RH
approach 6 repave with hot mix.
20 Crack, seal required along frontage.
MSTA770 Misc. Inspection / / / / 05/08/95 #-I shear wall; see inspection notes A/N KS 05/09/95 KBS
MSTA795 Mechanical Final / / / / 06/30/95 PASS Rd 06/30/95 RB
MSTA79'7 Plumb Final / / / / 06/29/95 PASS MS 06/30/95 MRS
MSTA797 Plumb Final / / / / 06/30,'95 PASS RD 06/30/95 RB
Page No. 2 --ASE HISTORY FOR CASE NO. MST95 0106
COSTA PAC*PIC HOMES
11742 SW TALLWOOD DR
08/19/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent: Done Done Date By
MSTA799 Building Final / / / / 06/30/95 PASS RB 06/30/95 RB
MSTA960 (F) Tssue Cert. of Occupancy / / / 06/30/95 JF 12/27/95 JF
MSTB708 Erosion Control / / / / 06/29/95 PASS USA 06/30/95 RB
CITYOF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 SW Hall Blvd.Tigard,Oregon 9722306199 (503)639-41171 PERMIT MST9!5010L
W Iiif DATE ISSUEPS 03/22/95
I 1 1:; i4l)DRIESS. 1 1 79,". SW TALLWOOD DR PP CELt 1S133CD--Jki`900
IUSU I V I El ION. . . . t VIC"PwALECRELK ZONING: R25
LOCI . . . . . . . . . . . LOT. . . . . . . . . . . . .
131UP-DING
?E I SSUE:MST94--0437 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 S f
-LASS OF WORk. NEW BEDRMS:4 BATHS:3 GARAG.. . . . . . . . . . :::,4U .i f
YPE Of: USE. . . 2'3F i.-LUUR REQUIRED SETBACKS----------
YPE OF: ("'ONST. :5N F IP; F. Lr_F- -) ft RIC311'r. -.9 1,
,L;LUPHNL:Y 6HP. IR3 SECOND. 850 s F'RONT. ,E:0 ft REAR. . :&E f t
TOR I F'S. . . . . . . .a FiNSSMENT:0 s REGIU I FRED—-
FIGHT. . . . . . . . 12& ft TOT AL--------:2078 s SMOKE DETECTORS. :Y
t-L')U1,t LOAU. . . -.40 p i f OPLUE. . . . . $ : 14.. c,4 6 PARK INC SI-_'ACES.
-em_-tv,Rs: PATH I
...... PLL
LNKS. . . . . . . . . . : i F:LC)OIR DRAINS. . . . BALKI':LOW PR EVNI H6. . :
V"I Uf<-[Lb. . . . . 14 WAfER HEATE:N ). . . 1 R114PS. . . . . . . . . . d . . . :0
JB/SHOWER(G. . . . . ,-.1 LAUNDRY TRAYS. . . -Vl CATCH BASINS. . . . . . . :0
A1ER CLOSETS). :3 SEWER LINE (ft ) . :0 GREASE' TRAP5. . . . . . . :0
�SAAWASHERS. . . . 1 WATER LINr (ft i . . 100 OTHER FIXTUREG. . . . . ..0
1ANBRGE L)IbP. . . - I RAIN DRAIN (ft ) . .LA
f4SHING MACH. . . : 1 51" RAIN DRAIN._), . . 1
MECHANICAL FLLS
JEL TY1 'L-�:--------------- UNIT type a m 0 1.m t by date r-ec p t
VENTS tO TIF $ 1!55LA. 00 JF LA3/E2/95
1x INPUT10 13 TO VF--N I FANS. . :4 SWM $ 100. 00 JF 03/�F.22/9'b
JRN ( 100K . . .-0 HOODS. . . . . . . I SWM $ 180. 00 JF 03/22/95
ARN i =10014 . : I I OODSTOVES. -0 BPRI 1 54.3, 00 ,Jr 0,3/,:;:�: 5
.41uh CLO DRYERS. : 1 50. 110 JD 03/09/95 95--26 '-/10
OTHER UNITS 1 851-1- 1 '1. 15 J 1 0.--3
GAS OUTLET E� I PARK 1 511110. 00 Jr'
4L. 0111 J F- 0 3
JSTA PACIFIC HOMES MPLC $ 11. JF 03/22/95
125 GW CASCADE M51-:11 J. 5 JF 03/1_'2/9!5
'
t46 38TH $ ec."i. 00 JF 03/.;12/95
..AVF..4%R1(JN OR ') I005 P5 I.-.,1 9, 1 1. :'S JF V",'s/G C.,/9 b
;or)& #: EROS t 64. 00 JV LA6/22/95
80 JF 03
HOMLS $ 20. 80 JF 03/a2/95
11030 '`3W OSPREY OR :0. 00 J1. '2t3 L/9 lb
&/5
AVi-IRION OR 97007
itl.Tie 50,-, - 64E-88A8
.9 #. . : 65157
3400. 50 I'OTIAL
.i per-sit it Issued subject to the repAitions contained in the RLUUIFI-1.) INSPEcTJONS
-
:yard Muricipal Looe, State of Cre. Specialty Codes and all other Footing Insp Plumb lop Out
applicable laws. All work will be done in accordance with approved FOUnclation Insp F=raming Insp
plant, This persit wil., empire if work is not started within 10 Post/Beam StrLtct '- irepiace Lnsp
aays of issuance, or if work is suspended for sore than 180 days. Post/BeAffl rvihan Gas Line Insp
7 C-r-avil Drain Ills'-liation 111sp
F.Imllm;(Jstmi, Insp 1.3yr) bo�Av-d insr,
FILM/Jndet-floor Re-..tirl drain Int,
I'ler.,hanic--al Insp Water- Line lnt_
Call for inspr- f i
__J
CITY OF T I GARD SEWER CONNEC11ON
PE p1r,1-11
COMMUNITY DEVELOPMENT DEPARTMENT P,ERMIT #. . . . . ,— : SWR95-0IL44
13125 SW Hall Blvd.jigare,Oregon 97223*8199 (503)839-4171 DATE ISSUED: 03/2i?/9'5
PARCEL: 161.--33CD-12900
SITE ADDRESS. . . : 1119L 'iW TALLWOOD DIR ZONING: R-25
SUBDIVISION- - PIEBBt-ECREEK
r,LOCK. . . . . . . . . . .* LOT.. . . . . . . . . . . . . :022
--------------------
TENANT NA14F. . . . . .. FIXTURE UNITS. . .
IIS'A P40. . . . . . . . . . :
CLASS OF WORDWEELL I NG UNITS. . :
K. . . :NEW NO. OF BUILDINGS: 1
rYPE OF' uSF. . . . . 36F J!YIPERY SURFACE. -
INSTALL -1 Y PL. . . . :BUSW R
Remarks : PATH I
Owner: --- ___.____.___
►"EES
wner: F-EES
COSTA PACIFIC HOMI:`5 type amalint L,,' dAt P recpt
AC125 SW CASCADE !`'RMT $ 2200- 00 JF 03/22/95 —
315. 016 JF 03/22/95 —
m.AVLRJUN UH 97005
une #- 50-s,-646-8888
�ntractor-
*
)NTRACTUR NOT ON F11—E
----------------
-,one al.P:.35. Oq. TOTAL
a g #. REQUIRED INSPECI IONS
This Applicant agrees to c0sply with all the oules and regulcaions bewpy.. Inspection
cf the Unified Sewage A111-CY. !he persit expires IPA days ft-01
the date :ssued. The total asount paid will be forfeited if the
pef�jit expires, The Agency does not judrantee the accuracy of the
side sewer laterals. If the sewer is not located at the seasurevent
given, the installer shall prospect 1 teet in all directions frov
the aistance given. !f not sr, located, the installer shall purchase
a 'Tap and Side Sewer" Pervit and the Agency will install a lateral,
e r m i tt ee 6 i 111nat —t.1
J&4
ssued By :
Call far insFrer tion —
639-4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
So la.r o,K. 2Cn/e
(503) 639-4171 C-6 r Pt,C `-7
Jobsite Address: 11792 SW Ta llwuod Drive WOMEN
Subdivision: Pebble Creek
Lnt# 22 Office Use Only
Valuation: _ 431-12 Y f0 L
Permit # _ S/ !
Corner Lot? Y N
Fceissue of ST 9y 0�/-3-4
Flag Lot? Y N
Map & TL # 15 1 '3'3 C,t,--
Owner: r'OA}A par-i f i -i4nma' — Approvals Required
Address: R62S SW Cascade Rlud 4606 Planning . _-____,.
Beaverton, OR 97005
_ Engineering
Phone. 646-8888 —�_ Oths
Contractor: SAME - Items Required
Address: Subcontractors __-
Truss Details
Phone: Other
Contractor's License # 65157
(attach copy of current Oregon license)
Contact Name & Phone: Marci Weber 646-8888
Subcontractors: Architect/Engineer: Lu ,
Plumbing: Wolcott Plumbing f Address: 151 Kalmus Drive C. 140
_
Mechanical: Arco Installations Costa Mesa , CA 92626
(attach copy of current OR Contractor's License)
Phone: ( 714) 549-3479 _
JOB DESCRIPTION:
Applicant Signature & Phone numper
7 17
Received by: / _ Date Received: _
Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) J —
_ Plumb. Permit (PLUMB)
Mach. Permit (MECH) ` Z)
State Tax (TAX) � 0 L •� �lJ �- ) /
Bldg:
Plumb:
Mech: a_L'
Plan Check / (PL,ANCK)
Bldg: S,
Plumb:
Mach.
a
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) ;/ 3 J/
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R) / (j,
Mass Transit Tlf
Commercial TIF (TIF••C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-OI _
Water Quality (WQUAL)
Water Quantity (WQUANT) -Lv
Fir,, Life Safety (FLS) —
Erosion Cntrl Permit. (ERPRNIT)
Eiosior Planrk/USA (F.RPLAPI)
Erosion Planck/COT (EROSN)
TOTALS:
`�iiii� �� C tl `r •.S� /
ciy-2(rZ��£s
SCALE DRAWING
LOT 22 PEBBLECREEK
o 1 �
1
210
EL EV. 02.
g.9 r
\ tJ 4.01 53 E
ATE AL
SqN 1
I}?ARY�___ — � 4 I
a , PL A► 2 2A CR R w
g o I
�
-� a 1
I -
' I' �—.T. LI
2.4
� 0 SCALE 1 - 0'
I
Z I\ __� r.
� , NOTES:, I --HORIZONTAL CONTROL FROM PIAT ^F PEBBLECREEK,
WASHIN:3T'ON COUNTY SURVEY PLCORDS.
1 ��' ` ` --VER'1CAL CONTROL FROM .NFORMATION PROVIDED BY OTAK
RAIN DRAIN__ _.___._---__ E1,Ev. 202. !
92,92 P' ON DISKETTE. CONTRACTOR SHALL VERIFY EXISTING CONDITIONS.
GRADES, AND ELEVATIONS.
WATER LATERAL E
o I
-- N 847 2 --EIGHT FOOT PUal. -
U IILI'rY Ek;EMENT ALONG THE FULL LENGTH OF
m E!-EV. 211 EACH LOT OR TRACT FRONTAGE ALONG ANY PUBLIC STREET.
--ER0;90N CONTROL
I PWOR TO rHE PLACEMENT OF ANY FILL OR COMMENCEMENT OF
L
'
SANITHRA� AL '—�� N GRADING WORK, ALL REQUIRED ER0".�ION CO►JTROL MEASURES
SHALL BE IN PLACE, INCLUDING:
•INSTALLA i'1ON OF A GRAVEL DRIVEWAY CLEANED AND
REPLACED AS NEEDED TO KEEP CLEAR OF DIRT;
I INSTALLATION OF SILT BARRIERS, *'RICH SHALL REMAIN
IN PLACE UNTIL THE GRADED AREA HAS BEEN PROVIDED
I l WITH A PERMANENT GROUND COVER (I.E BARK DUST,
i
N
o MUASS, OR OTHER LAN ; THE S BE COUNTERSUNKD5INNTO THE GROU DLT BARRIER
SIGNED ON
PROFE5901NAL
LANG SURVEYOR SCALE D R A VVI N G LOT 2:.. PEBBLE CREEK
N.W. 1/46SEC. 6,T.3S.,R.1W..W.M
OR_R------- CITY OF TIGA D
11792 SW Tallwood Drive XLY ia. 19017 WASHINGTON COUN i'Y OREGON
_ MARCH 8 199 Centerline Concepts Inc.
�f 1
WADE G.22276 0�'AN DRAWN BY: BP CHECKED BY: WGp III
RENEWAL nN DECEMBER 3?, 199' n 640 82nd Drive Gladstone, Oregon 9702 '
SCALE 1 =10 ACCOUNT 1 587 503 650-0188 fax 503 650" 0189
r`
. "MIMY1�Mr -•,.L..'A��Mr:R'gFlk'.YfA�1:Fy,.r;Y7._4.,F.w,,.,rY .
TF THIS DOCUMENT IF LESS 111111 III 111 III II1 I I III 111111 I I Ill ' III 11 T�T 111 IIT III I I III 1�1 111 111 III III III I I III III III III l�l T�1 111 1 T T11 111 11Il111 III II1 1111111 III III IIII I
�r4f � � i � � i i �
LEG TBLE THAN '1'H1S NOTATION, ; --- —� ��-- -"-� ^_�L� -�__ � —' _—_ �L— _ S 1O 1Z.
IT I. llUF 1'0 THF, QUALITY OF
36
THE ORIGINAL DOCUMENT. N. _
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