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CITY CF TIGARD
DEVELOPMENT SERVICES
13125 SW Nall Blvd.,Tigard,OR 97223(503)639.4171
C!'PT I F I CAT'E OF
OCCUPW IC Y
K[ f1MIT 1t. . . . . . . : MST97--0466
DINE ISSUED: 04/19/98
PARCEL : 2S105AC'-05600
SITE ADDRE 3 y. . . : 1233 5 SW 15 3RD TERR
SUDDIVISION. . . . . MORN ING'_3IDE ZONING:F1--"5
BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . :004 .JURIGDICTIUN:UREt
CLASS OF WORD. a NEW
'FYPE OF USE. . . -GF
TYPE_ OF CONSTR;SIV
OCCUPANCY GRP. s F43
OCCUPANCY LOAD-.2'
R u m ar k a ; SF - Path I
WE 13TERN GLEIN DEVELOPMENT
.18057 SW LOWER BOONC S FERRY RC1
i i�;iaRD OR 97224
Phone d#: 6c:0--4400
WESTErR14 GLEN DEVELOPMENT INC
18057 SW LOWER WOWS F'Rly' RD
T I GARD OR
!-4ione # .- 62121-4400
Rug #. . : 0007621
"Fhi s Certificate grants occupsknc}- of the above referrer;^ecl building or portion
t;horoof :and confit-ms that the building has been intpec_ted for compliance with
the State of Orpgoyl Sper_.ielty Curies for the gro'..cP, occupancy, and use ender.
,4hich the r�eFer•enced permit- was isSr_red.
nUI DING 1 SRE.0 Cf )Ft INS CTI SUPERVIt3Ctr7
P05T IN CONSPICUOUS PLACE
L3
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J
)14
CITY OF TIGARD BUIL
DING- DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: — S~ G/ A.M. P.M. MST:
Location: 1�2—23ff , CiJ 153,1/'t/ BUR
Tenant: Suite: / -$7ldg: W-C:
Contractor: 92 r`i 1 Phone: E 9 3'-�( /r�/—7 PLM:
Owner:— / t Phone: 4�y�r�=, 7 / ELC:
ELR:
SIT:
BUILDING —BLDG(con't) C _PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam' Post/Beam Cover/Service Scwcr4%Qnn
Footing Roof UndFl/Slab Rough-In Ceilinga er mem
Slab Framing To Out Gas Linc Rough-ht Iii , -erer
Foundation Insulation ` crI Ilood/Duct Reconnect Vault
Bsmt Damp Dry-wall StormFurnace Temp Set-vice MISC.
Masonry Ceiling atn am - A/C UG Slab
Shear/Sheath Fite Spklr/Alm Dr I lent Pump Low Volt _
Approved Tfi'L!E" Approved Approved 9tIS(ue�e d—
Appr/Sdwlk Not Approved irovcd Not Approved Not Approved i roved
FINAL FINAL FINAL FIN '
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O Cell for reinspection CI Reinspection fee of S. if required before next inspection CI Unable to inspect
Inspector: 2 Date: / / - Page _of /
CITY OF TIGARD MASTER P'FCRMIT
DEVELOPMENT SERVICES 17'ERMIT #. . . . . . . . MST97- 17-14C,F:
13125 SW Hall Blvd.,7798rd,OR 97223 (503)6394171 DOTE I SSL)ED: 10/31/97
F,A RCEL: 2S 105AC-0~6 00
T'r AIII)RC yS. » . : 1 '`37' SW 173RIZ T E R R
112DIV11:310 d. . . . :MORNINGSIDE 70h41t4G: R"'E'er
'_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . .004 JURISDICTION:
":sarks: Sr - Path 1
----------------- ------------------------------------------ BUILDING - -- ------ -------------------------------------------
;SS'JE: STORIES......,: c FLOOR AREAS---------- BASEMENT...: 0 sf REQU'RED SETBACKS---- REOUIRED-------------
`_ASS OF WORK'; HEIGHT........: 20 FIRST....; 899 sf GARAGE.....: 418 sf LEFT....,.....; 16 SMOKE DETECTRS: Y
TYPE OF USE...: FLOOR LOAD....: 40 SECOND...: 871 sf FRONT.........: 20 PARKI';G S^ACES
TYPE OF CONST.-5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT.........; 5
OCCUPANCY GRP.:R3 BDRM: 4 BATH: 3 TOTAL------: 1770 sf VALUE.,$: 125803 REAR..........: 21
-.---_..__. --------------------.._------------------------------- PLUMBING -----------------------------------------------------------------
SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 PAIN DRAIN ft: 100 TRAPS.........: Q
LAVATORIES....: 4 DISMSHERS...: 1 FLOOR DRAINS,.: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TIJB/SHOWERS...: 2 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATFF LINE 4t^ 100 BCKFLW PREVNTR: 1 GREASE TRAPS..; e
OTHER FIXTURES: 0
--------—--------------_--_.---—___------.---__----__w-- MECHANICAL
FUEL TYPES----------- FURN ( 10 ..: 1 BOIL/CMP ( 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 1-
GAS TURN )-1000, ,.: a UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.......... 0 WOODSTOVES...... 0 GAS OUTLETS...: 1
_._..------------------._---_....__-____._---_------- ELECTRICAL -------------_-.-.-__---_----__---_-.----_----.._---..------_--_-_-_
--RESIDENT'% 'UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUF---- --ADD'L INSPECTIONS--
1e70 SF OR LESS: 1 C - 200 alp..: 0 0 - 200 alp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPEC71ON: 0
EA ADD'L SW.: 3 201 - 400 amp..: 0 201 - 4010 asp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT; 0 PER HOUR......; 0
LIMITED ENERGY.: 0 40 - 600 app..: 0 401 - 600 app..: 0 EA ADCL BR CIR: 0 SIGNALIPANEL...; 0 IN PLANT......; 0
MANF HM/SGC/FDR: 0 50' - 1000 amp.: 0 601+amps-17100 v: 0 MINOR LABEL -10: 0
1000+ alp/volt.: 0 ------------------------------------- PLAN REVIEW SECTION ---------------
Reconnect only.: 0 )=4 RES UNITS..; SVC/FDR)=225 A.: > 600 V NOMINAL: CLS AREA/SPC DCC:
-------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ____________.____..__.._---__.._____....-_.-__------------
A. SF RESIDENTIAL-----.-..------------------- B. COMMERCIAL-------------------------------------------------------------------_---------
AUDIO I STEREO.: VACWM SYSTEM..: AUDIO X STEREO.: FIRE ALAW.....: INTERCOM/PAGINGs OUTDOOR LNDSC LT:
BURGLAR ALARM,.: OTH: :s X BOILER.........: HVAC...........; LANDSCAPEIIRRIG: PROTECTIVE SIONL:
GARAGE OPENER..: CLOCK..........; INSTR'M, TATIOI: MEP,ICAL........: OTHR;
HVAC...........: DATAI'ELE COMM.: NURSE CALLS....: TOTAL r 5YS7yS: P
Owner: ..-_____ ___._ ____..________. ._.._--Contractor. -- - _.__.___---_------ TOTAL FEESA 3W.Lul
WESTERN GLEN DEVELOPMENT WFETERN SLEN DEVELOPMENT INC This permit is subject to the regulations contained in the
18057 SW LOWER BOONES FERRY RD 18057 SW LOWER BOONES FRY RD Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97224 TIGARD OR 97224 other applicable laws. All work will be done in accordance
with approved plans. 'his permit will expire if work is
-ne #r 620-440e Phone #: 62e-44e0 not started within 180 dais of issuance, or if the work is
Reg #..s 000762 suspended for more than 18e days. ATTENTION: Oregon law
_.___..___....._.-. -____---_-..------------..._---_--_-._-_- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rAes are set forth in OAR 952-P014010 through OAR 952-@014080. You may obtain copies of these rules L�-
direct questions to OUNC by calling (5031246-1987.
----------_-..-------_.------------------------------------- REQUIRED INSPECTIONS --------------—---------------------------__-_--_____..
J Erosion Control Crswl Drain Electrical Rough Gas Line Insp Water Line Insp Plaeb Final
coating Insp PLM/Underfloor Fraying Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp `_
J ''ost/Bear Str lumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post/Bear an ctr;-y: Fireplace Irsp Rain drain Insp MecIa '_51
rG'iUf-`" I'', r'('I-mitter 5ignatr_t: f �.
11 1 I ,._I.{4 t. ! I 1 1 1. . r +.1 .+ 4 ., -1 A l l +..{..,I. 14..i. . 1 i I I r i ! i ! i I r ! 17
r
Com' -41 '-`7 by 7:00 p. m. for• an irrspec:t i oti n re tts ine s dray
AN155
unified
sewerage SANITARY•agency
SURFACE WATER U
. f=irst Ave.,Suite 270, Hillsboro, Or.,97124
503 648.8621
CONNEC:TIM PERM) T
ISS)Ur. IJAI'I: 10111397 E:XPIRATYON ))ATI:: 042190 rC r:XP LIATE 102399 F''I�RMTT 113470
STRUCTURF ADDI.F.K. J ,?93,'t F'RCI,JI:C'I 463,5
STRIIi;TI.IRE O Rb,k:'r 13W 1,3.Mi rFRR
L.01 4 81. O(:K
T'YPF. CONNECTION— NEW OF 14ORNINGSTDE
1 'YPF= INSTALLATION— ( 19) F11-11 ctWl't/I:.I;CI CON/SM:
TYPI-'.' I:)I',,rIIPANCY ( 1, ) a [NI.)I.1`7 FAMTI—Y PARCEL. 231 1 AC 5600
till: SEC 441.4 MH 249E10
OWNER WE9 TFRN l31_F'N OEVFI..OP �+
ADDRESS 18057 SW I OWER E1l)t1NI S F"RY TRI:ATME:N1 PI. ANT TMRHAM
TtGARD OR 97224
PHONE 620-4400 WATLR DISI RT CT 'I J.GARD
FIXTIIRF- I:C>UIVAI I.*.NY DWF.;I.IlNS RESIDF.N1:1Al.
LIN TTS 9E.RVI1:E: UNITS 0.0 IJN [ 15 1 SERVICE UNtTS 1.
CONNFCT I ON E E V is SLIRI'AM' WA')L R T.II::VL:I.OPMLNT F V VS
SFWI.;:R 110NNECT ICTN 2200. 00 WA1'IM QUAI..'ITY 210 .00
LESS (,RF:DIT < P.10# (:0
WA I'1 R QUANTITY 290.00
L-ES!', CRFDIT < 0.00).
EiRUS 1.UN (:1.)N I PL'11.
:INfs'PF.CTICIN 64 .00
P1_0N CHECK 41 .60
I
SU4l'O1"AL ?:'.00 .00 t3118T111'AL 395.60
T[1'r AL 2!i95.67
APDL. PlAMf: t;AYI.E' PI INI.(1 . . _ ..
AFFILI IA1Il1N OWNER
RF14ARK::i PRO ► 46331 ► 0I 4 • MORNINGSIDE
J *24 HOUR Kr��F F•kIi',' � I.IN" !.il'I: G I ] C►N�+ I:I ILII l lel li
1me. r, T C ' 1344• 4 * 4>k>k>K
UMR
LL, /
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Permit Conditions: a applicant Agrees to immply with all rules and regulations of the Unified Sewerage Agency. When calling for an inspection, please
refer to the Permll tuber,. The Permit expires one hurMred eighty (180) days from the date of issuance The Agency does not guarantee the accuracy
of the location of side sew laterals
7/93 WHITE - USA, BLUE - Accounting, GREEN -Inspection, YRLLON - Customer
Plan Check# "-
CITY OF TIGARD Residential Building hermit Application Recd By ^►J _
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd It7-tl
TIGARD; OR 97223 Single F3mily Detached or Attached (Duplex) Date to P.E. -
V•503-639-4171 Date to DS b *o---F 503-684-7297 Permit#
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Prop.
roje N
Job D �� / '06
Site Address_ Architect Mailing Address
Address v + 4'
N ma� / tat Zip Phone
Owner Mailin Addresse
/Sta �/
ity ` /t� ngineer Mailin Address
te ZI Phone
G T7 t 1. 1I
c_
Zip fphbne
General Nam Ct/ / alt �'��. c� 17 r'
Contractor ( )- ��✓ Describe work N w Addition Alteration O Repair O
Mailing Address to be done:
Prior to permit Additional Description of Work:
issuance,a copy City/State Zip Phone
of all licenses
are required if Oregon Const.Cont.Board Exp. ate PROJECT /
expired in COT Lie.# lC VALUATION
database _
3
Mechanical Name ( VVjr NEW CONSTRUCTION ONLY: _
Sub- \7f - ,�. Sq. Ft.jou e( Sq. Ft. G r e
Contractor Mailing Address w _ _:' —
Prior to permit Corner Lot YES NO Flag L t YES NO_
issuance, a copy City/State Zip Phone (check one) c. (check one) "
of all licenses Restricted Audio/Stereo Burglar
are required if Oregon Const.Cont. Board Exp Date Energy S stem_ At,irm
expireddatabase Installation Uc.#
Installation Ga ar ge Door HVAC
Plumbing Name / Opener Systems
Sub- (check all that Other:
Contractor Mail) g Address apply) -Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit Cdy/3tate zip Phone
issuance, a copy Has the Subdivision !plat recorded? N/A YES NO
-
of all licenses are Oregon Const. Cont.Board Exp Date
required if Lic.# Reissue of MST# Solar Compliance
expired in COT (Calculation Attached) _
database Plumbing Lic.# Exp. Date I hearby acknowledge that I have read this application,that the
information given is correct, that I am the owner or authorized
Name — agent of the owner, and that pla submitted are in compliance
wilh Ore _ 1a
Electrical l I ) N caner/ LDat —
Sub- MallingAddress
� 7
Contractor on� Phbhe
City/State Zip Phone
y Prior to permit FOR OFFICE VtE ONLY:
Issuance, a copy Plat#:
r- MaplTL#: �
—' of all licenses are Oregon Const. Cort, Board Exp. Date
L1required if Lic# Setbacks Zone: , > �" lad 1 1)
expired in COT
W database Electrical Lic.# Exp. Date
—' Engineering App al: Planning Approval: TIF:
a.,, (Y�
VITM
Y '(l 3 I:SFREM DOC (DST) 4/97
�Y11P ki 1�.1.1' �i
i
CITY-OF TIGARD Site Permit Application
13125, SW HALL BLVD. mmercial: Complete ENTIRE form
TIGARD, OR 97223 Residence.: Complete SHADED areas
(503) 639-4171 x304
Print or Type
Incomplete or illegible applications will not be accepted
Project Igant-' r_; Utilities(Complete all that apply)
Job ) i _ --
Address Address Storm Sewer
( tr' Linear Ft.
ame 1. / Sanitary Sewer
Lk %F T'. t,,0 � 'l6,rc�J�d,� Linear Ft.
Owner Mailing 4 dress / �/ f t Frp7h Water
4 i�) ` )) t C't� 7 �h te r. .. .��,i a, _ Linear Ft.
CitylState r Zi Phone Catch Basins
Gi;nerai a Clean Outs
Contractor #
Prior opern-A Mailing,Address Describe work to be done:
fasuk xY of aAddition(:]nce,a
CVDNew[] AdditionAlteration[] Repair[]
Neenah are City/State Zip Phone Additional Description of Work:
regmed ,f
exOp�T State Const. Cont. Board Lia . a �
t�
Name I Project
_ Valuation $ '
Archi-:ect Mailing Address Plans Required: See Matrix on h ck
_ The following,must accompany this application: _
---- City/State Zip Phone Site plan with Vicinity Map Parking(including
Showing ADA compliance ADA)&Llghting Plan
Name Grading Plan and details Landscaping Plan
Engir eer Mailing Address Erosion Control Plan and Retaining Structures
details including calculations
City/State Zip Phone Site Utility Plan and details Soils Report
(showing connection to (if required)
approved system}
Excavation Volume 1 hereby acknowledge that I have read this applicaEon,that the
(Soils report required for>5,000 cu. Yards information given is correct,that I am the owner or authorized
cu. yds. agent of the owner and that plans submitted are in compliance
with Oregon Stalp-lMs
Fill Volume sighatv nr1Age `� Date
(Soils repos equired for>5,000 cu. Yds.)
cu. ds. - l��r /
Will the fill support a structure ntsct a Phone
`.'.
(Engineer required if answer is res) YES NO
s �•
Retaining structure? (check one) ❑Rock FOR OFFICE USE ONLY
>- [] CMU Notes:
J ❑Concrete
L
❑Other
W Total new imeervious area including all Land—Use Case
J
buildings, sijl� walks, and paving Sq. Ft.
sitenpp.&0/97
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL. TOTAL CPE PPE EPE CPE PPE EPE
SITE —�-- l 1 -- -- T 3 (j,o,u) -- --
B (N,--w or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 0,o,f)
M (New or Add. or Alt) I 1 -- -- 20,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) 20,o)
B & M & P (New or Add.) 2 l 1 -- 3 (j,o,w) 20,o) -
E (New, Add, or Alt) 2 -- -- 2 -- -- '(j,o)
B & M & P & E (New. Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
B or B & M (Alt) I I -- -- 20,o) --
B & NI & P(Alt) 3 1 l •• 20,o) 20,o) --
B & M & P&. E (Alt) -T 3 1 } L-2 (j,o)
NOTLS
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = NIEC
updates and adds actions. f= Fire P = PLM
u = USA E = ELC
b. Shaded areas designate ALT submittals only. w = Wash. County F = FPS
U.
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
L
approved plans to be forwarded to their office.
L; Exception. continue to Forward a copy of approved fire sprinkler and fire alarm plans with
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calculations.
h\matnc Doc
TSR M"ITER IXTURE UNITW HS EM
Contractor Name z ✓ 1� ° / CY, 11L A--0-4-
Billing Address g�� '� L� �^l� ��� e✓ l/2
Site Address of New Meter f �� (-A-� 1 P c y
Lot# f. Subdivisiont/�LA
Please fill in the number of each fixture as detailed on the plans, then multiply quantity by the point value given to arrive at the
point total. Add all point totals together for total fixture unit points.
Fixture Uri quantity Point Value Point Total
Hose Bibs X 3 = i _
Toilets ,� X 3 =
Bath Tubs X 2
Shower Stalls `� X 2 =
Lavatories X 1 = _
Kitchen Sink X 2
Laundry Sink X 2 =
Bar Sink _ X 2
Clothes Washer X 2 = _
Sprinkler Heads X 1 =
TOTAL FIXTURE UNIT POINTS
Meter Size: Meter Cost: _
_5/8"x1/4" 1..
Total Fixture Unit Points< 32 = 5/8 " x 3/4" meter Bulll Mountain Area $1832.00 $3584.00
Total Fixture Unit Points>33= 1 " meter Lower Elevation $1311.00 $2542.00
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Fixture Count Verified with Plumbing Permit
Meter#
Receipt#
Emp Name
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