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12621 SW 138TH PLACE
1Q(Al SW 138or"AVENUZ Ll. H. 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Oi OOi aOp t7N1 N N It'Y N N O O O N O h h O O t` ^ t- n h h r ti U h a (n (n w (n (n (n (n (n (n cn cn (n (n (n (n cn E\�)a 2=� �= =]) / e - 2R \\\\[ E co LL ° /a9 6aQQQ£ E \ &� e2 } \ �\ /\\ i CL cn k 7 $ k /£ / ( ( ( §_ % / ,a> 2] � � f 2 a_ & a_ a ` a $ V) a ± � @ 3 E § / § § % 2 � @ �0 \ 2 U n � k \ \ \ } $ \ $ CD r4 > j 2 2 \ / § § 0 A � r \ � � § � o 7 % § / E c e i � \ ® 2 % 2 $= t . ~ a t \ 2 f » ■ / ¥C) I m J E LO y © m % $ m © > § 2 k a 2 t � WF- V) U) (n B d 0 2 Off J J J J CC CL Ql lD r*1 CO M ,a 6 U Z � J r Ict O d 0 Q Mn a z N0 a n_ N a) T I.b m d C '^ O I rn cn d 7 y.� r TF d O O H r � O � a �, a V U O An yI N V a LO A N O � a to r H t a, N N C LO `o " P W a J 4 _O y O c d y�� $ M y CL N 3 ChO O N O In ' O N 0 Cl CITY OF TIGAHD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 63.3-4171 Inspection:__—` _ Footing Susp. Ce,'ing Sprink. Rough-in Appr/Sdwlk Fuundation Plbg. Under:.lab Mech. Pough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL- Post/Beam Mech. San. Sewer Gas Line (-OIdg. Plbg. Underfloor Rain Drain Framing -Plumb Alarm Water Line Insulation -1Gec Underflr. Insul. Shear Wall / Gyp. Bd. -Elect. Date Requested:_ I �� r �1 S� Time: AM __PM Address: =� C, v� ( / 741 Jk-�-t Buildor. Permit fl:THE FOLLOWING CORRECTIONS ARE REQUIRED: a ce -- — F- Ln Lo W ` Inspector:� L -- --- - Date: �"' Z✓` / ` APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. MASTER PERMIT CITY OF TIGARD PERMIT ##. . . . . . . . MST15-036 COMMUNITY DEVELOPMENT 6100iISIANT DATE !SSUED! 09/28/95 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171 PARCEL. ;2;-;-104,:D-RMIt719 SITE ADDRESS. . . 12621 SW 138TH AVE SUBDIVISION. . . . : ROSE MEADOWS ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :019 BUILDING REISSUE: DWELLING UNITS: 1 BASEMENT. .. . . . . . . :0 sf CLASS GF WORK. :NEW SEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :440 sf TYPE G" USE. . . :SF FLOOR AREAS---------- REOUIRED SETBACKS-_--_..-_-_-_..-. TYPE ETBACKS-----------TYPE OP LONST. :5N F71RST. . . . :780 sf LEFT, . : 12 ft RIGHT. :6 ft OCCUPANCY GRP. :R3 SECOND. . . : 738 s FRONT. :30 ft REAR. . :34 ft STORIES. . . . . . . :2 FINBSMENT:O sf HEIGHT. . . . . — :22 ft TOTAL----- -: 1516 sf SMOKE DETECTORG. :Y FLOOR LOAD. . . . :40 psf VALUE.. . . . . 105313 PARKING SPACES, . : 1 Remarks : PATH I PLUMBING .3 I N K c... . . . . . . . . . : I FLOOR DRAINS. . . . :0 BACKFLOW PRT:VNTR!;. . : l LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :2 LAUNDRY TRANS. . . : 1. CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE ( ft ) . :0 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . tl WATER LINE (ft ) . - 100 OTHER FIXTURES. . . . . !0 5ARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :O WAGHING MACH. . . : 1 SF RAIN DRAINS. . : 1 --------------- MECHANICAL -------------------------------- FEES -------------- - PUEL TYPE5----------- UNIT HTRG. . :O type amo'..Iot by date recpt 153 AS/ VENTS . . . . . :0 TIF $ 1590. 00 D 09/28/95 95-271079 MAX INPUT:O BTU VENT FANS. . -4 1-31411 $ 180, 00 B 09/28/95 95-2710711 TURN ( 100K . . : I HOODS. . . . . . . I SWM $ 100. 00 Z� 09/28/95 95-27J079 TURN .-100K _-0 WOODSTOVEG. :0 DPRT $ 448. 00 B 09/28/95 95-271079 FLOOR TURN. . . . :0 CLO DRYERS. : I SPLC 1 291. 20 JA 09/22/95 95-270860 BOIL/CMP < 3HP;0 OTHER UNITSil B5PC $ 22. 40 B 09/20/15 95-271079 GA5 OUTLETS: 1 PARK $ 500. 00 B 09/28/95 95-271079 Owner: ----------------- ----------------MPRT $ 43. 50 B 09/28/95 95-271079 JAY MILLER MPL11 $ 10. 88 B 09/28/95 95-271079 P 0 BOX 230459 M3PC $ 2. 18 P 09/28/95 95-271079 3BTH t 225. 00 B 09/28/95 95-271079 TIGARD OR 57281 P 5 r-,C; $ 11. 25 B 09/22/95 95-27 1079 Phone #: 684-7543 EROS $ 64. 00 9 09/26/95 95-271079 Contractor; -----------------------------ERPC $ 20. 80 8 09/28/95 95-27107? JAY MILLER ERVC $ 20. 80 S 09/28/95 95-171079 PO BOX 230459 1 TIGARD OR 97281 CL Phone #: 684--7543 Req #. 300109 ---------------------.___._______._____ $ 3530. 01 TOTAL This pet-sit is issued subject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Dre. Specialty Codes and all other Footing Insp Plumb Top Out applicable laws. All work pill be done in accordance with approved FoundatiDn Insp Framing Insp �J plans. This persit will expire if work is not started within 180 Post/Beam Struct Fireplace Insp to dos of issuance, or if work is suspended for oore than 180 days. Dostl!Tleam Mechan Gas Line Insp Permittee Si nature - 7 .r-awl Drain InsulAtion Insp Plm/undslab Insp Gyp Board Insp AM, AA A L FIL.M/Underfloor Rain drain Insp Issued By: L%Z k.M. P-1 k' 14 Mechanical Insp Water Line Insp Call for inspection 639-4175 SEWER CONNECT I Onl CITY OF TIGARD PERMIT PERMIT #. . . . . , : SwR95-041 ' COMMUNITY DEVELOPMENT WPARTjMF4NT DATE ISSUED: 09/28/95 13125 SW Hell Blvd.Tipera,Oregon 97223.8199 (503)839.4171 PARCEL: 213104BD•-RM019 SITE ADDFiIrSS. . . 12621 SW 136TH AVIS SUBDIVISION. . . . : ROSE MEADOWS ZONING: R--7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :019 TENANT NAME. . . . . : USA NO. . . . . . . . . . . FIXTURE UNITS. . . . CLASS OF WORK. . . :NEW DWEL_L.I NG UN 11-9. . : I TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . :BIJSWR IMPF_RV SURFACE. . : : Sf Remarks : PATH I Owner-: -- _---•.-----______.__.______________.._------.----.__._.__.___-- FEET; JAY MILLER type amol_tnt by date recpt; P O BOX 2:304!9 PRMT $ 2200. 00 B 09/28/95 95-217079 INSP f 35. 00 B 09/28/95 95-217079 TIGARD OR 97281 Phone #: 664-7543 Contractor: --- --------------_.______.__.__ CONTRACTOR NOT ON FILE ''hone #: f 2235. 00 TOTAL Req #. . . — _-- -- REQUIRED INSPECTIONS -----_.._ This Applicant agrees to comply with all the rules and regulations Sewer, Tnspecti.on of the Unified Sewage Agency. The permit expires 180 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 A ency will install a lateral. 1=1er•mittee 519nature : T s,3 1_t a cJ By : 114 Call for inspection — 639--4175 1 iJ _J r L:= Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # ELL q5-G'A I'1 _ Phone (503) 639-4171 Date Issued CITY OF TIGARD FAX (503) 684-7297 issued t _� TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: � 14. Complete Fee Schedule Below: Name of Development t (� �UIJ� I Number of Inspections per permit allowed Address 4D- 1A) tb tl�/L I Service included Items Cost(ea) Sum Gity/State/7_ip I i4, 4s. Residential- per unit �1 4 1000 cq it ur leas I $11000 11! Name (or name of business) l Il Each additional 500 art it or 50 port $2500 on thereof 1 Commercial ElResidential EachLimit-id Energy $2500 2 Each Manul d Home or Modular i nwelluig Service or Feeder $86 00 2a. Contractor installation only: 4h.Services or Feeders Installation,alteration,or relocation 2 Electrical Contractor ��� �'� �e Oil U _ 200 amps or leas $6000 2 Adaress s-,- 1E u 1 201 amps to 40U amps $6000 401 amps to 600 amps $12000 2 City Y Stat@ ZIP 601 amps to 1000 amps $16000 2 Phcne No. __�r) ? Over Q00 amps or volts $14000 2 Contractor's License No. Z2Tl�. RG Reconnect only $5000 Contractor's Board Reg. No. td�!Jda g 4c.Temporary Services or Feeders Ins'allation,alteration,or relocation 4 Signature of Suppr-. 7500 �►Elec'n11200 amps or less $50 00 _ 2 License No. Q LII 5 Phone No. - 201 amps to 400 amps _i $ 2 401 amps to 600 amps $tn000 Over 600 amps to 1000 volts 2b. For owner installations: see V above 4d. Branch Circuits Print Owner's ":ame _ _ New,alteration or extension per panel Addressa)The lee for branch circuits with purchaser of seryke or boder W. 2 Ciry _ State Zip Each branch circuit E5 00 Phone N0. t)The lee for branch circuits without The installation is being made on property I own which is purchaser of serryke or Nader fee. 2 not intended for sale lease or rent. First breech circuit E 00 _ r Each additional branch circuit $5 E5 DO Owner's Signature _ 4e. Miscellaneous (Service or feeder not included) 3. Plan Review section (it required): Earth pump or irrigation circle $4000 _ 7 Each sign or outline fighting $4000 Signal eirruit(s)or a limited energy Please check appropriate item and enter lee in section 58. panel,alteration or extension $4000 4 or more residential units in one structure Minor Labels(10) $10000 _ Service and feeder 225 amps or more System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the alloy-ole in any of the above p- erlion $11,00 as described in N E C. Chapter 5 Per inap -- ---- � Per hour $5500 In Planl $5500 A Submit 2 sets of plans with application where any of the above —'— >_ apply. Not required for temporary construction services. 5. Fees: .i NOTICE 5a. Enter total of above fees $ r., 5%Surcharge(.05 X total fees) $ e Subtotal $ _ - PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b.Enter 25%of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF _J CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. ❑ Trust Accountill $ Balance Due $ _� �n.1..nr4v Wr rim xrp A � � t q-� Residential Building Permit Application Tigard r C)� F'�5 too"-' SW Hall Blvd. >,5l' i�p \ems �e` drd, OR 97223 '03) 639-4171 Jobsite Address: Subdivision: '. M&VIOWS Lot# Office Use Only 1( % Contact Date / / Initials Valuation: /0,5Result _ New Construction Only: (Square Footage) Planck/Rec # Permit #�t_ .o� 3 _ House: _ Garage: l _ Reissue of _ Map & TL # .r._ S, U' iD 1-; Corner Lot? �y . N Flag Lot? Y N Zone _ Owner: Plat # Address: 2'f // Approvals Required Planning Setbacks Solar 1Q �)� ���� Engineering _ Phone: `1 / - ���1 Other _1 — --" Contractor: Spit Items Required Address: Subcontractors Truss Details Other Phone: ( I Notes Contractor's License # - (attach copy of current Oregon license) Contact Name: l -E --- Contact Phone: Subcontractors: Arch itect/Engineer. Ccit K11 Ii �J glumbing: �CT C.G� �, 47 -`1S Address. ��� x ),3--7s`1 o k Mechanical:_ _( ✓� _Lj( '`( r (attach copy of current OR ontractor's License) // 9nn Phone: ( ) (P - bloQo } �- JQ6 DESCRIPTION: _ J Sq Applicant Signature Applicant Phone number J Received by: CI1 _ Date Received: H UOVIWInvNwe Permit# Account Descnption Amount AML Pd. Bal. `'IJSf1�-S 0.3G� Bldg. Permit (BUILD) C Plumb. Permit (PLUMB) L) _ Mech. Permit (MECH; State Tax (TAX) Bldg: ;2_2. 4 0 Plumb: // Z Mec,.: , / Plan Check (PLANCK) _ Bldg: ! Plumb: L� LAY Mech: S� 'Xy)-0 / l Sewer Connection (SWUSA) �2aU Sewer Inspection (SWINSP) 3 Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) I Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WOUAI_) Water Quantity (WOUANT) is J� Fire Life Safety (FLS) i= Erosion Cntrl Permit (F-R r Erosion Planck/USA (ERPLAN) 7t' 4�, � ,f d Erosion Planck/COT (EROSN) TOTALS: Cal S :v r 77 D U u p r ✓ � 0 El 30 LIL LL ` vim C>_ ; n' L.► �/ �� �,-, ERMIT CITYOFF,LUMBING P TIGARD PErJ11T #. . . . . . . : MSTI:45--036--;, COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSI'P-D: 09/28/95 13125 SW Hall Blvd.Tiga,d,Oregon 97223*81199 (503)639-4171 PARCEL: 2S1-04BD--RM019 SITE ADDRESS. . . : 1,2-621 SW 138TH AVE SUBDIVISION. . . . . ROSE MEADOWS ZONING: R-7 BLOCK. , . . . . . . . . : I-OT. . . .. . . . . . . . . . 02 CLASS 01:-- WORK. . :NEW GARBAGE DISPOSALS. . : 1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : I BACKFLOW PREVN'T'RS. . : 1 OCCUPANCY GRP. . :R3 FLOOR -',PqINS. . . . . . . :0 T k r4 PS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0 FIXTURES------------- LAUNDRY TRAYS. . . . . . : 1 SF RAIN RA I NS. . . . . : 1 SINKS. . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . :37 OTHER FIXTURES. . . . . :0 'TUB/SHOWERS. . SEWER LINE (ft ) . . . . :0 WATER CLOGE--T'*;. WATER LINT: (ft ', I.00 DIGHWAGHERC". . . . : 1 RAIN DRAIN (1_t ) . . . . 0 Remarks : PATH I OWNER: JAY MILLER TIF $ 1590. 00 B 09/28/95 95-271079 P 0 BOX 220439 SWM t 180. 00 0 09/28/95 95-271079 GWM $ 11110. 00 B 09/28/95 95-271079 TIGARD OR 97281 BPRT $ 448. 00 B 09/28/95 95-271079 Phone #,-. 684-7543 BPILC $ 2.91. x'0 JA 09122195 95-270860 B5PC $ 22. 40 B 09/28/95 95-271079 Plumbing PARK $ 500, 1,10 B 09/28/95 05-271079 MPRT $ 43. 50 B 09/28/95 95-271079 flame : IYIPLC $ 10. 819 B 09/28/95 95-271079 AddrIes s M5PC 1. 2. 18 B 09/28/95 95-271079 3BTH $ 'c.:5. 00 B 09/28/95 95-271079 Z i n Plhonp# `8/95 95-271079 P5PC $ 11. 25 D 09 C2 Pr-q # Additional fees n o t shown hr--�.. . . . . . . . . ——————— REPUIRED INSPECTIONS This pe! mit is issued subject to the reg— ulations contained in the Tigard Municipal Footina Insp Insulation Insp Code, State of ffi-e. Specialty Codes and all Foundation Insp Gyp 2o;-:krd Insp other applicable laws. All work will be done Frost/Beam St t-uc Resin drain Insp in accordance with approved plans. This Post/Beam Mpchan Water Line Insp permit will expire if work is not started Crawl Drain W.,' er Service In within 180 days of issi-tance, or it work is Plm/undslab Insp Appr-/Sdwlk Insp �.,uspended for more than 180 days. FILM/Underfloor Mechanical Fina] Mechanical Insp Plumb Final Plumb Too Out Building Final Framing Insp Erosion Control Vz Fireplace Insp o& /i�/;;l V Gas Line Insp �� - Authorized Plumbic'g ractor Signatute Call for inspection -- 639-4175 Contractor Notes : CERTIFICATE OF CITY OF TIGARD OCCPANC PERMIT #. . . U. . . . : Y MST95. COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 01/25/96 13195 8W Hall Blvd.Tigard,Oregon 972230199 (503)639.4171 PARCEL: 2r3104bD--RM019 131 TE: ADDRESS. . . e 1262.1 SW 138TI-4 AVE SUBDIVIS-ON. . . . ROSE MEADOWS 70NING:R-7 BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . :019 CLASS OF WORK. :NE=W TYPE OF UESE. . . , OCCUPANCY GRP. .. OCCUPANCY LOAD.E Remarks : PATH I Owner- JAY MILLER P 0 BOX 230459 TIGARD OR 97281 Phone #r 604-7543 Contractor.- ---- - JAY MILLFR PO BOX L,30459 TIGARD OR 97L231 Phone #t 684 -7543 Req O. . s 300109 This Certificate Lp-,Ants occupancy of the above rpferencerl build:.npi or portion thereof and confirms thm.t the building has been inspected for compliance, with the State of Oregon 5pecialty Codes for the group, occupancy, and t..ise under which the referenced permit was issued. BU I ING IN't-PECTOR BUILDING OFFICIAL POST IN CONSPICUOUS PLACE L