Case File t
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Pagn 1+0. 1 CASE HISTORY FOR CASE NO.: MST97-0203
ROSE MANOR HO"QsS/GSI NW
12037 SW 96TH PL Unit: PVT
06/05/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent. Doue Done Date By
MSTA092 (F) Inoue combination permit / / / / 07/08/97 PASS DRA 11/09/97 J•H
MSTAo95 Inoue plumbing signature form / / / / 07/28/97 RECD SW 07/30/57 S•W
MSTAG97 Inoue electric signature form / / / / 08/01/97 RECD SW 08/01/97 S•W
MS':A720 Mechanical Inep / / / / 10/30/97 PASS KS 11/10/97 J•H
MSTA722 Plumb Top Out / / / / 10/02/97 PASS MS 10/02/9'1 MRS
MSTA730 Fireplace Inep / / / / 08/06/97 q-1.- interior side of separation wall at A/N KS 08/06/97 KBS
upper level
mud/ tape horizontal joint between
walls connection
MSTA735 Gas Line Inep / / / / 10/30/97 Gas piping = 21.5 psi PASS KS 11/10/97 J•H
10TA960 (F) Isnue Cert. of Occupancy / / / / 05/14/98 06/05/90 JT
MSTB005 Application received / / / / 05/29/97 RECD JD 06/12./97 BON
MSTB008 Permit created / / / / 06/12/97 PASS B 06/12/97 BON
MSTBO10 Check for prel. restrict. / / / / 06/12/97 Check conditions of approval for MEMO B 06/12/97 BON
StTB94-0007 before issuing
MSTBUI2 Plans routed to Plans Examiner / / / / 06/11/97 PASS H 06/12/97 HON
MSTBo26 Bldg/meth plans apprd by CPE / / / / 06/18/97 APPR RDP 06/19/97 RDP
MSTB027 Rlectrical plana apprd by VPH / / / / / / 06/12/97 BON
MSTB028 Plumbing plans apprd by PPE / / / i / / 06/12/97 HON
M.9TB030 Reviewed plane routed to DSTS / / / / 06/18/97 RDP 06/18/97 RDP
MSTB032 DST Plan Review completed / / / / 06/20/97 PASS 0 06/20/97 BON
MSTH700 Erosion Control / / / / / / 06/12/97 BON
MSTB705 Footing Inep / / / / 07/09/97 PASS TLP 07/11/97 J•H
MSTB705 Footing _nap / / / / 07/11/97 PASS TLP 07/21/97 J•H
MSTB706 Foundation Inap / / / / 07/18/97 Approved as noted: 1. Install anchor PASS KS 08/21/97 J•H
bolts size 6 spacing as shown
2. center foundation vent at rear wall.
CL PAIL KS 08/17/97 J•H
MSTB710 Pont/Beam Stractural / / / / 07/25/97
t-' MST8710 Pose:/Beam .4:ructural 08/27/97 / / 07/28/97 PASS KS 08/27/97 J•H
to gagB;II Font/Beam f49chanical / / / / 07/25/97 PAIL KS 08;27/97 J•H
MS"3711 Poet/Beam Mechanical 09/27/97 / / 07/25/97 PASS KS 08/17/97 J•H
--I MSTB712 Plm/Undc?,floor / / / / 07/25/97 PASS M9 09/27/97 J•H
MSTH713 Crawl Drain / / / / 05/15/99 PASS TLP 05/18/98 J•H
MST8723 ' ectrical Scrvice / / / / 05/15/98 PASS TLP 05/18/98 J•H
I1.1
PASS HRP 10/29/97 J•H
—j MSTB724 Electrical R,nlgh-in / / / / 10/29/97
Page No. 2 CASE H1STGRi FOR CASE NO.: MST97-0203
ROSE MANOR HOMES/GSI NW
12037 SW 96TH PL Unit: PVT
06/05/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Vpd
Code Sent Done D Ale Date By
--- --- -------- ---
MSTB725 Mechanical Inap / / / / 10/:.4/97 1. Preecure not adequate for test (gas FAIL KS 10/15/97 J•H
piping) .
2. Secure insulation at sides and rear
of fireplace.
3. Secure insulation shield at b-vent
(attic).
4. Connect exhaust fans.
5. Firestop mechanical chase at urger
level.
6, Mechanical soffits not built in
garage.
MSTB725 Mechanical Innp / / / / 10/20/97 1. Adjust b-vent above furnace FAIL KS 10/21/97 J+H
clearance.
2. Connect. exhaust fans and extend to
roof jack.
3. Wall around duct at upper level.
4. Support gas piping.
5. Soffits not built at garage (mach).
6. Support vertical gas piping adjacent
to furnace.
KSTB725 Mechanical Inap / / / / 10/28/97 PASS KS 10/29/97 J•H
MSTB725 Mechanical Insp / / / / 11/07/97 Approved an noted: PASS KS 1.1/09/97 J•H
1. Soffits not built at mechanical
(garage) .
2. Secure fireplace.
3. Add stud at rectangular duct at upper
level.
4. Gan piping 28 psi.
MSTB727 Low Voltage / / / / 03/06/99 PA=iS BRP 03/09/98 J•H
M.9TB729 Plumbing Top Out / / / / 10/01/97 no test on waste FAII. MS 10/01/97 MRS
CIL,
H
In M9TB730 Framing Inap / / / / 11/12/97 Approved as noted: PASS KS 11/14/97 J•H
1. Complete collar at stick cut rafters
H
�-
(will be rechecked at insulation).
J
2. Call for reinspection - mechanical.
C.7
Ill
J
Page No. 3 CASE HISTORY FOR CASE NO.: MST97-0203
ROSE MANOR HOMES/GSI NW
12037 SW 96TH PL Unit: PVT
06/05/98
Action Description Req/ Schd/ End/ Action Notes Diap By Update Upd
Code Sent Done Done Date By
METB730 Framing Inap / / / / 10/28/97 1. Provide detail f.:om TJI provider, FAIL KS 10/29/97 J+H
cover angles cut above garage header.
2. Provide kin.- stud each aide of glulam
al: garage and strap across platen.
3. Add stud at splice at kitchen.
4. Strap platen notched for plumbing at
halfbath.
5. Strap glulam to post at kitchen.
6. Positive connection trimmern to
header at garage.
7. Provide king stud at each aide of
beam above stairs.
8. Provide eive ba`_flei at vaulted
ceiling above atwirs.
9. Collar ties at stick cut raftere.
CALL FOR REINSPECTION.
MSTB730 Flaming Inep / / / / 11/07/97 Framing corrections not complete FAIL K3 11/0:./97 J-H
MSTB730 Framing Inap 12/09/97 / / 12/01/97 PASS KS 12/09/97 J•H
MSTB740 Can Line Inap / / / / 10/20/97 see mach snap this date FAIT, KS 10/21/97 J-H
MSTB740 Can Line Inap / / / / 11/0'7/97 28 psi PASS KS 11/09/97 J•H
MSTB745 Insulation Innp / / / / 07/28/97 PASS KS 08/27/97 J•H
MSTB745 Insulation Inap / / / / 11/17/97 PASS KS 11/17/97 J•H
MSTB745 insulation Inep 12/09/97 / / 12/01/97 PASS KS 12/09/97 J•H
MSTB750 Shear Wall Inap / / / / 09/29/97 This inspection includes generic panals. PASS KS 09/29/97 J•H
MSTB'155 Firewall Inap / / / / 09/04/97 Approved as noted: Interior side of PASS KS 09/08/97 J•H
aeparatioi wall at upper level.
C- MS7'0760 Gyp Board :..ep / 11/20/97 1. Shear walls need nailing at both FAIT. KS 11/20/97 J•H
...., / / /
aides of common wall.
f-
2. Nail gypsum at separation wall w/ 1
� 7/1•-inch nails ao 7-inches OC.
J3. Separation walla need to extend :.o
under aide of xcof sheathing.
D7
4. Firetape all vertical and horizontal
LLT joints And spot nail.
J
MST8760 Gyp Board Innp / / / / 11/21/97 PASS KS 11/23/97 J*H
MSTH760 Gyp Board Inap / / / / 12/01/97 PASS KS 12/09/97 J*H
MSTB775 Rain drain Inap / / / / 07/24/97 Requires clean outs for rain drains. PASS MS 08/27/97 J•H
MSTB775 Rain Drain Inap / / / / 07/28/97 Needs Cole on raindrains per MS FAIL RAM 08/27/97 J*H
Paa_e No. 4 CASE HISTORY FOR CASE NO.: MST97-0203
ROSE MANOR HOMES/GSI NW
12037 SW 96TH PL Unit: PVT
06/05/98
Action Lescription Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTH780 Water Line Insp / / / / 08/26/97 Pressure reducing valve at meter. PASS WA 08/28/97 J•H
M.9TB785 Appr/Sdwlk Insp / / / / / / PVT N/A 05/14/93 JT
MSTB796 Electrical Final / / / / 03/06/98 General Contractor: Gaps around outlet PASS BRP 03/09/98 J•H
not to exceed 1/9-inch, NEC Art. 370-21.
Gape around ruceesed fixtures.
MSTB797 Plumb Final / / / / Ci/17/98 1. Provide cleanout at kitchen sink. FAIL TN ,3/29/98 J+H
2. Provide approved clean out
fitticq/storm sewer with threaded plug.
3. Seal hone bibbe at aiding.
4. Secure hose bibbs at siding.
5. Sccure vertical piping/water heater
safety valve drain line.
6. Seal shower valve flange at. wall.
MSTB797 Plumb Final / / / / 03/24/99 Seal rear hose bibb at siding - see PASS TN 03/29/98 J•H
roport 031798.
MSTB798 Mechanical Final / / / / 03/24/98 Approved an noted: 1. Support gas piping PASS RS 03/26/98 J*H
.tjacent to water heater at horizontal
section. 2. Support b-vent at
horizontal.
MSTB799 Building Final / / i / 05;01./98 1. Replace window in upstairs bedroom- FAIL WDJ 05/01/98 WD-1
does not meet energy code (broken)
2. Remove debris from underfloor area.
3. Remove dirt fror underfloor vents.
4. Provide min. 1" clearance between
B-vent and combustible material.
S. Provide step, between houne and
garage/
6. Locate and expose crawl drain and
backwater valve.
/
ti
F
MSTB799 Building Final i / / / 05/15/98 Previous corrections completed. PASS TIA ''I ,:.1�
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
CERTIFICATE OF
OCCUPANCY
PE:RMI T #. . . . . . . e MST97--020 a
DATE ISSUED: 05/14/98
PARCEL: 151 KIBA—O.sEI00
SITE ADDRESS. . . : 12037 SW 96TH PIL #Fv'T
`XIBD I v I S I tON. . . . i DUBLIN PARK ZON I MG-R--25 PD
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . ..003 ,JURT.SDICTIUNiTIU
CLASS OF WORK. c NEW
TYPE. OF USE. . . n SF'A
'TYPE OF CONSTRz5N
OCCUPANCY CRI'. s R3
OCCUf=,ANCY LOAD.2
Remarks . WA - Cvth 1
Ownere
ROSE MANOR 1 0ME5/GSI NW
CONSTRUCTION
106;:?0 SW LUCAS DR
TUAL_A'T IN OR 97062
Phone #a 452-8.13.3
Gontr•actora
ROSE MANOR HOMES INC
JW20 SW 1_.UCAL3 DR
TUALATIN OR 97062
Phone #0 452-•8133
Reg #. . r 109A613
This C;er,ttficarte yr,tnts occuF)anr_v of the abovo referenced building or portio ,
thereof and confirms that the buildiny has been inspected for compliance with
the State of OrepQ11 Specialty Codes Far, the rgr'oUp% ocr,.upar-,Cy, and uee under
wh4)ING
e referenced pf+rmit was i %sued.
v
NUTNi-iPECTOR 1L/I41GE�TIO &(36PAIVSUii
J
POS1 IN CONSPICUOUS PLACE
w
J
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: J
u
' eq S l � ( � —� A�J.M. P.M. MST: ' C�Z 69�
Location: Z - D 3.7 BUR —
Tenant: ` Suite: Bldg: MEC:
Contractor: Phone: (> ��.�-" / PLM:
Chimer: Phone: ELC:
ELR:
_ SIT:
BUILDING $�/1 PLUMBING MECHANICAL ELECTRICAL SITE.
Site I os icam PosUReam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing 'fop Out Gas Line Rough-In 1JG Sprinkler
Foundation Insulation Sewer I food/'Duct Reconnect Vault
13smt Damp I."vall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire ' r/Ahn 4/Found Dr I leat Pump Low Volt
A»rove Appiov(.d Approve(: Approved Approved
Appr/Sdwlk of Approvvd Not Approval Not Approved Not Approved Not Approved
NAI; FINAL FINAL FINAL FINAL
H�
D Call for rri, c n R,ntilx clion Ice of S `rryuir v before xt inspection O Unable to inspect
Inspector __ Date ( Page of
e( - � — —
CITY OF TIGARD MASTER PERMIT
DEVELOPMEN f SERVICES PERMIT #. . . . . . . : MST97-0203
DATE ISSUED: 07/08/97
13125 SW Hall Blvd,,Tigard,OR 97223 (503)639.4171 'J
T� PARCEL: 251 0c:Afl-+?t✓800
SITE ADDRESS. . . : 1 '037 SW 96TH PL. ##PVT
SUBDIVISION. . . . :DUBLIN PARK, ZONING : ?-E:5 PD
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :008 JURISDI"TION: TIC)
Remarks: SFR - Path 1
-------------------------------------- ------- BUILDING,
REISSUE: STORIES.......: 2 FLOOR AREAS------ ---- B11SEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.:NEW HEIGHT........: 21 FIRST....; 782 sf GARAGE.....; 464 sf LEFT....,.....: 5 SMOKE DETECTRS: Y
TYPE OF USE...:SFA FLOOR LOAD....: 50 SECOND...: 704 sf FRONT.........: 20 PARKING SPACES: 2
TYPE OF CONST,:5N DWELLING UNITS: t FINBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 2 TOTAL------: 1486 sf VALUE..1: 107617 REAR..........: 20
---------------------------------------------------------------- PLUMBING -----------------------------------
SINKS.........: 1 WATER CLOSETS.: 2 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 100 TRAPS,........: 0
LAVATORIES....: 4 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 0 CATCH BASINS,.; 0
TUB/SHOWERS,..: 2 GARBAGE D1SP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
--------------------------------------- MECHANICAL ---------------------•-----------------------------------------
FUEL TYPES------------ FURN ( 100K ..: 0 BO11_!CMP ( 3HP: 0 VENT FANS.....: 2 CLOTHES DRYERS: 1
GAS FURN )=tff. .,: 1 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 1
MAX INP.: 175000 BTU FLOOR FURNACES: 0 VENTS.........: I WOODSTOVES....; 0 GAS OUTLETS...: 1
--------------------------------------- -- ELECTRICAL -------------
—RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- ---ADD'L INSPECTIONS--
1080 SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp.,; 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 3 201 - 400 amp..: 0 201 - 400 amp.. : 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MAW HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ------------------
Reconnect
---------------Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=2225 A,: ) 600 V NOMINAL: CLS AREA/SPC OCC:
---------------------------------------------------- ELECTRICAL .. RESTRILIED ENERGY -----------------------------------------------•------
A. SF RESIDENTIAL--------------------------- B. COMM..RCIAL-------------—------------------------------------------------------------
AUDIO d STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH, :; BOILER........... HVAC,..........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARr,GE OPENEP..: X CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC......,.,.. DATA/TELE COMM. : NURSE CALLS....: TOTAL t SYSTEMS; 0
Owner ---- -- ---------------------Contractor: ------------------------------ TOTAL FEES:f 4036.06
ROSE MANOR HOMES/GSI NW ROSE MANOR HOMES INC This permit is subject to the regulations contained in the
CONSTRUCTION 10620 SW LUCAS DR Tigard Municipal Code, state of Ore. Specialty Codes and all
10620 SW LUCKS DR TUALATIN OR 970& other applicable laws. All work will be done in accordance
TUALATIN OF 97062 with approved plans. This permit will expire if work is
On Phone t: 45?-8133 Phone 1: 452-8133 not started within 180 days of issuance, or if the work is
Reg C.: 109868 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 952-1301-2010 through OAR 952-001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (583)246-1987.
-------------------------- REQUIRED INSPECTIONS - --------------------_--___ --------------- .. _-----
Erosion Control Post/Beam Struct Plm/undslb Insp Plumbing Top Out Shear Wall Insp Appr/Sdwlk Insp
Grading Inspecti Post/Beam Meehan Electrical Servi Framing Insp Firewall Insp Mechanical Final
Footing Insp Plm,'Underfloor Electrical Rough Gas Line Insp Gyp Board Insp Building Final
Foundation Insp Crawl Drain Mechanical Insp Gas fireplace Water Line Insp
Wtr Proofing Slab Insp Low Voltage Insulation Insp Water vice In
�, / f �
IssUed B Permitte,- Signature:
1-+++++A-++ +++ ++++++i++++++• ++++*+++++•+++++++++++++i-44+++•++++++++++i+++++•++ F
Call 639-4175 by 6:00 p. m. for, an inspection needed the next business day
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT
PERMIT #. . . . . . . : SWR97-02,00
DATE ISSUED: 07/08/97
I':'E"-.kCEL: 2S 102 BA-038OO
SITE ADDRESS. . . : 12037 SW 96TH PL #PVT
SUBDIVISION. . . . :DUBLIN PARK ZONING: R-25 PID
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :OO8 JURISDICTION: 7IG
TENANT NAME. . . . . :ROSE MONOR HOMES
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0
CLASS OF WORK. . . :NE, DWFLL.(NU UMTS. . : 1
TYPE: OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL_ TYPE. . . . :BUSWR IMPERV ':" rRFACE: 0 sf
Remarks : SFA — Path I
Owner: - ---___---- ------- __— --_ -- - --_— — ______------ .....- FEES
ROSE MANOR HOMES/GSI NW type amoo_rnt by date recpt
CONSTRUCTION PRMT R 2200. 00 DRA 07/08/97 97--::96888
10620 SW LUCAS DR INSP $ 35. 00 DRA 07/08/97 97-296898
TUALATIN OR 97062
Phone #:
Cont r,ar.t or,: ------------------ _------.----
OWNER
Phone #: $ 2235. 00, TOTAL
Reg #. . .
REDU I RED I NSPECT I ONS ---- --This Applicant agrees to comply with all the rules and regulations Sewer Inspection _
of the Unified Sewage Agency. The permit expires 188 days from
the date issued. The total amount paid will be forfeited if the
permit expires, The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" 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
9510-801-0018 through OAR 952-0001-0080. You may obtain copies of
these rules a questions to OUNC by calling (583)246-1987.
Issl.ied _ . ..0 Farmittee Signatur-e:
4-4+++++t++++++++. .......4.....+++. 4.....++++++.... .....++++.+-F++++............4
Call 639-4175 by 3:00 p. m. for- an inspection needed the next business day
++++++++++++++++. .....+++.+++++++++++++++++++++4.+++++++++++++*+++++..... .....+++
Plan Check M
"Y OF ;IOARD Residential Building Per mit Application Recd By —
Z5 SW HALL-BLVD. New Construction Additions or Alterations Date Recd Osc -
-;BARD, OR 97223 Single Family Detached jr Attached (Duplex) Date to P E -to--
503-639-4171 Date ro DST
503-684-7297 Permits ^�T`t1` %0= �ca1K'-17 -
Print or Type called OZaD
Incomplete or illegible applications will not be accepted
Name of Project Name
Job
,&Cv/1,0
.�l �L/n,� funk _
Address I S%Ite Address Architect Mailing Address
rIA
P 4,". CitylState Zia Phone
) Hca L�1-1�D t a? .'oc,
Owner M71 I ng Address
coistale Zip Phone Engineer Mailing Address
rb ! Cil n Of 70c''t 4 51i)—b/ 3-2 /C'J "_'-1
C t�,state
Name Zia Phone
General 0escnbe work New Addition O Alteration O Repair O
Contractor ailing Address to be done
&) "t('6t, Q.Q. Additional Descnptlon of`Nork:
Citwstate Zip . Phone
Oregon CyQnst Cont. Board L c s Exp Date
Attach Copy of
Current COT Business Tax or Metro 0 Exp. Date PROJECT t
Licenses VALUATION $ �' ''" & I0-7 (0 f
Name _
Mechanical 1 NEW CONSTRUCTION ONLY:
�z `, �"6 S Ft. House: S Ft. Gana e
SUb- Mailing Address q q. g
Contractor /�5 j; ;�1,11� _
C; rState Zip Phone — Corner Lot YES NO, Flag Lot YES NO
S j�� (check one) L' I (check one)
regon onst. Cone Board L c s Exp.Date Restricted / I Audio/Stereo Burglar
Attach Copy of ; j�.;_� I Eneray System Alarm
Current l COT Business Tar or Metros Exp. Date Installation Garage Door �, HVAC
Licenses �� �
Opener
Nam 'J (check all that fL Other. ✓ Systems
Plumbing . i111�'rC�ory �c'i4ANtC-0 t:_ apply) _ I
Sub- Vtawng address WiN the electrical subcontractor wire_ for all YE$ I NO
:ontractor/ Q/ C Cjz i� 5 t/ d restnc'ed ?nergy mstallationsl c'
C:yState Zip T ph n Has the Suoclvlson Plat r,?corded? NIA YE,S NO
each cony or r-gon Cwnt. Board Lica i Exp Date Reissue of NIS74 Solar Ccmpliance
Current I Plumbing L!c s i Exp. Date I (Calculation Attached)
icenses J i hearoy acknowledge that I have read this application. that the
--� information given is correct. that I am the owner or authorized
CDT Business rax or Metro x ! Exp Date agent af'he owner, and tha ofans submitted are in compliance
� I
•-. Name with Gosaon Sta s
Signal w r(Ac:n Date
Electrical >
L,
-�
Sub- Mjifing Address
Conta P rsgn ame c� Phone x
l'ontractor / /<''O `lJ ��G�.E'C /�►+ t� — �'�� � S�, ����.
C.rf.S'a:e Zia Phone FOR OFFICE VJ SE ONLY:
6,t -t.-773 Pat ' via L1�:
Oregon Zane Cant. Board L c s Exo Date
?.ane
,ach Copy of 00- S 0 -aI Setb s: I ( S018r,
Current E'ec:ncal Lie. s Ex Date ?7-
_aenses 3►{ 2,S C /b-I - 1 c"n Ineenn or val: P'anrnn A
9 g p I prova( TIF
COT Business Tax or Metro a Exp Oate � I(.•/ t� f �L.�,
74 1 3/- S'� .'sf po.doc;dst) 1;97
Pe-mit Ac,- ni n s tion Amount AML .L gal. Dcl®
MST. Permit (BUILD) �" 3 -
Plumb. Permit (PLUMB) /��;" 1�5� �•!
Mech. Permit (MEC H) yj
ELC/ELR Permit (ELPRMT) %ay _ 2 "`✓
State Tax (TAX)
Bldg:
Plumb: _1i?
Mech: _1 J
ELC/F_LR:
Plan Check
MST: 2L-)
Plumb: (PLMPLN)
I
Nfech: (MECPLN)
CDC Review
(LANDUS) l,-i� CCC'-BSD r; ✓
C
Sewer Connection (SVJUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF•R) !j�v ✓
Mass Transit TIF (TIF-MT) I A U / 2w -✓
Water Quality (WQUAL) I Eo
Water Quantity (WQUANT) _ f I� /(!b -�✓
Erosion Control Permit (ERPRM T)
J I
Erosion Planck/USA (ERPLAN) 70�
Lail I
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS) .)
TOTALS'
r/i.lsfacadac tdscl 1197
dK
97 Mov 28 18.10:08 R:\LT\LT7-BDP SATURN IM.R.R.)
X007
?fl�Iul. ZS BY
ROSE MANOR HOMES, LTD.
IPH.I 452-8133
i;, 7`r,(,t;/i)o CITY OF TIGARD
C�f�vt 2 S i0Z T" - U 370 D DUBLIN PARK LOT 7 - 12059 S.W. 96TH PLACE
— p3go0 LOT 6 - 12037 S.W. 96TH PLACE
NOTE.
✓%- '� GRAVEL DRIVEWAY ENTRANCE
17'.6- 51' 7'
PER EROSION CONTROL
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ALAN YASCOW DE541h ASSOC'.ATES.INC \�
K 1#01 L"Ll FOA 14 ACCAPPACr LX TK
TOPOGRAPHY/FORMATION 11 6 THE SOLf _ l ----
PfSPONS19kitr CY 1-9 DLILDEP TO VIOW1
ALL SITE CfMdTODWS INCLUDING AN'FILL
RACED ON14 Siff AND NPORM OWNFAS `\
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1305 N VV 18TH AVENUE, PORTLAND. OREGON 97209 1503) 225 9161 S C A L E t 2 0 0
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: _ �/ '_ q 7 A.M. _ P.M._ MST:
Location � � s BUP:
'tenant:_ __ Suite: Bldg: MPC:—
Contra .,r: Phone: PLM:
(honer. Phone: ELC:
ELR:
SIT:
BUILDING BLDG(con's) — PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam last/Beam Post/Beam Cover/Service Sewer/Stonn
Footing Roof Undl'I/Slab Rough-In Ceiling Water Line
Slab Framing To, t Gas Line Rough•In UG Sprinkler
I oundation Insulation _r I iood/Duct Reconnect Vault
Bsmt Damp Drywsll S onit furnace Temp Service MISC.
Masonry Ceiling (In–ii,Drain ? A/C UG Slab
Shear/Sheath Fire Spklr/Alnr .riW-1'70un6r l leat Pump Low Volt
Approved A ry Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL. FINAL
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O Call for reinspection C7 Reinspection fee of Srequired before next inspection O Unable to inspect
Inspector,��.__�__ Date:�.�� �_ Page`,or___ _