14202 SW 132ND TERRACE 1
14202 SW 132"" Terracc
ELEVATION CERTIFICATION
PER SECTION 710.1 of the OSPSC CY OF T iGARD
3510.1 of the OTFDSC OREGON
THE UPSTREAM MANHOLE RIM APPEARS TO BE ABOVE SOME; OR ALL
OF THE FIXTURE, SPILL IDMS 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 �c
SUBDIVISION
ADDRESS 1-y7 A 2 <,.
PERM[T#�lC�l�l7/
A TRANSIT SHOT ON (DATE)_ 0? HAS VERIFIED THAT THE FIRST
UPSTREAM MANHOLE SPILLRIM IS rI
CIIG"F�-fpft LOWER(CIRCLE
ON THAN THE LO EST 1F�INISH LOOR ELEVATION.
PLUMR_'.. Z"L DATE
BE
Tc-
JOB SUPERINTENDANT ` DATE
_V
ABOVE INFORMATION ACCEPTED AND APPROVED BV:
INSPECTOR
BATE
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772
._J
24-Hour -7
Inspection Line: (503)639-4175 MST o�=�,��7�
...v Business Line: (503)639-4171
� BUP --
Receive d� Date Requested �' AM PM BLIP
Location � �� Suite—_ MEC _—
Contact Person — — Ph(—) � � '�' PLM
Contractor--- -. ---- Ph(.-- —) --- SWR --- —
Tenant/Owner —.._— ELC —
Footing E —
Foundation Access: q
Ftg Drain f� � J -ew -- —
Crawl D in SIT
Slab Inspection Notes:
Post&B ---
Shear Anc rs
Ext Sheat ear ------ -- -----
Int Sheat Sh r
Framing — -- -- —--- ---
ati
Drywall ailing — -- --
Firewal
Fire S nkler --- — �iJ.4��.--- — QV•A —� -- ---
Fire Alarm -
Susp'd Ceiling —
Roof
Cllbfic ----PA§S PRT FAIL.
Post B
UndeS --- _ -- -- - ----------- — -----_..�_— -- ----- -
Roug
Water ervice __---
Sani Sewer
Rai ins - _.—._- ------ -- — --- - -
C .h sin/Manhole
ower n
r _
_ _ II—III-_._... - - ----------------
ina_ _ --
PASS PART FAIL.
R
N - -- — _ -- - _ ---- _ - ----- —
B
mpers T FAILTR a'L3 --- —
Rough-In — — --- - -
UG/Slab
Low Voltage C) - — -- -- —.. ------_.__.— ----- — - -
FWLAIarm
IFAS PART FAIL Reinspection fee of$___-__._-- required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
$ LJ Please call for reinspection RE: _ --_e72?,
Unable to inspect-no access
Fire Supply Line e
Approach/Sidewalk ADA Dote�_: :. 3 inspector _ Ext _—
Other:
Final DO NOT MOVE this Inspectse job Ao.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (5 -4171
INSPECTION DIVISION Business Line: ( 306.,
MST
BLIP
Received -- Date Requested_ — S'6;L-7 AM - PM Z° - BUP _
Location -- / O ��� �� - Suite MEC `
Contact Person _—_ Ph( ) PLM _
gFoundation
Ph (— ) _ SWR
Tenant/Owner _ _ ELC —`
—/-c�esss: ELC ELR Inspection Notes: SIT —
Post&Beam —. -- I�� • %-- � __—_ —
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ._�
Framing
Insulation
Drywall Nailing
Firewall c i
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _
Roof _/ -
Other: -_- ---- ,� V1.liV41
AS PART FAIL ----_
PL MBINa �( _ / —
Post& Beam `-- — — .
Under Slab � �
Rough-In -- - -
Water Service
Sanitary Sewer -- — -
Rain Drains
Catch Basin/Manhole - - —�
Storm Drain -- -- —_ --.
Shower Pan —�� ------ —�
Other: ---------
ina
-F'ASS PRLT AIL
Post& Beam
Rough-In
Gas Line — _ -------- --
Smoke_Dampers
FCSPART FAIL
ELECTRICAL
--T--_-__—_ _�,--
— —�— -
Service - ---- ----_,._ —
Rough-In ------��-- --
UG/Slab
Low Voltage
Fire Alarm - ----J--- - ----- - _____ _
Final rr-�-�
PASS PART FAIL u Reinspection fee of$__ required before next inspection. Pay at City Nell, 13125 SW Hall Blvd.
SITE _ l_.: Please call for reinspection RE:_ Unable to inspect-no access
Fire Supply Line —�-`—
ADA `�
Approach/Sidewalk Daft— ta___ lespretor---�y_ '— _ — Ext_.
Other: ---.
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Flour
BUILDING Inspection Line: ( 363►9- 75 6 71
INSPECTION DIVISION Business Line: ( 0 9.4171 MST
BLIP
Received _— Date Requested AM '' PM BUP
Location _ 3a' 7"..vvt Suite _ MEC
Contact Person _ '�V -� ph( ) a -54 6 _ --
PLM
Contractor _ -- Ph( ) _ SWR
BUILDING Tenant/Owner
ELC
Footing —
Foundation Access: ELC _--
Ftg Drain ..�G �
awl Drain ELR
Slab Inspection Notes: - SIT
Post&Beam _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �' cl 2, 4
Framing ming
Insulation ---
Drywall Nailing
Firewall , A �—
Fire Sprinkler ,---- _
Fire Alarm -
Susp'd Ceiling -
Roof
Other: - - _— -- — - -
A PART FAIL. - — --- - ---r---
GING i
Post&Beam
Under Slab
Rough-In tai
Water Service
Sanitary Sewer
Rain Drains -- - - --- ----- - ---- �---r — --
Catch Basin/Manhole '
Storm Drain - -- --- -"
Shower
AS PART FAIL --—- - - - ---
MHANICAL
- - --- ---
Post&Beam -- --- -Rough.In
In - -- -- - -- --
Gas Line
Smoke Dampers -
Final -- _
PASS PART FAIL
ELECTRICAL
------- ,----
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
- - -
Final
38_ PART FAIL El Reinspection fee of$—_______ require,.)before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA_ _
__§_1T It — ❑ Please call for reinspection RE _ Unable to inspect-no access
Fir Supply Line
ADA L _
Approach/Sidewalk Date - �_ Inspedoir L - Ext
Other
Final DO NOT REMOVE this IntsPOW0e r000rd from the fob she.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALT_ BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE fjECEI V ED
PREFERRED PLUMBING
3251 SW BARNET ST Gli Y Ur iiuh-Ku
FOREST GROVE, OR 97116-8651 13M DING DMSION
Plumbing Signature Form
Permit #: MST2032-00171
Date issued: 3i20iU2
Parcel: 2S109AB-09200
Site Address: 14202 SW 132ND TF_RR
Subdivision: RAVEN RIDGE
Block: Lot: 021
Jurisdiction: TIG
Zoning: R-7
Remarks: SIF Path 1 KEEP FIRE SPRINKLER PLAN WITH MASTER PLAN
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
OWNED: PLUMBING CONTRACTOR:
PALACE HOMES INC PREFERRED PLUMBING
27975 SW COX ROAD 3254 SW BARNET ST
COLTON '
v v� , JS97�+01-f
GvREvT v�7- -D - . . - -- .
Phone #: 503-816-5664 Phone #: 503-359-0560
Reg #: I it 132604
PI M 34-340PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
S 6m6iGre f Au ;rind Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
CITE' OF TIGARD MASTER PERMIT
PERMIT#: MST2002-00171
DEVELOPMENT SERVICE'S DATE ISSUED: 3/20/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 14202 SW 132ND TERR PARCEL: 2S109AB-09200
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT:021 JURISDICTION: TIG
REMARKS: S/F Path 1 KEEP FIRE SPRINKLER PLAN WITH MASTER PLAN
BUILr,NG
REISSUE.: STORIES: 2 _ FLOOR AREAS REQUIRED SETBACKS RE,UIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,535 of BASEMENT: of LEFT: 5 SMOKE DETECTORS:
TYPE OF UqP: rF FLOOR LOAD: 40 SECOND: 1.010 of GARAGE: 410 of FRONT: 21 PARKING SPACES- 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 5
VALUE: $247.023 70
OCCUPANCY GRP: R3 BORM: 4 BATH: 3 TOTAL -,51300 at REAR. 23
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 100K: BOIL/CMP<3HP: :ENT FANS: 5 CLOTHES DRYER: 1
GAS FURN�000K: I UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS. 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 20C amp: 0 200 amp: WISVC OR FOR: I ruMr IRRIGATION: PER INSPECTION:
EA ADD't.500SF: 4 201 400 amp: 201 400 amp tet W/O SVCIFDR: 0o SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 •600 amp: tol •600 amp. EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 601 • 1000 amp: 601+8"105-11000w MINOR LABEL:
10004 amp/volt
PLAN REVIEW SECTION
Reconnect only: �•4 RES UNITS: BVCIFOR>=225A s 600 V NOMINAL CLS AREAISPC OCC:
ELECTRICAL•RESTHIC TED ENERGY _
A.SF RESIDENTIAL _ B.COMMERCIAL.
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPFARRIG: PROTECTIVE SIGNL
GARAGE OPENER: CLOCK. INSTRUMENTATION. MEDICAL: OTHR:
HVAC: DATAfTELE COMM: NURSE CALLS: TOTAL a SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,433.86
T his permit is subject to the regulations contained in the
PALACE HOMES INC PALACE HOMES INC Tigard Municipal Code,State of OR. Specialty Codes and
27975 SW COX ROAD 27975 S COX ROAD all other applicable laws. All work will be done in
COLTON,OR 97017 COLTON,OR 97017 accordance with approved plans. This permit will expire If
work is not started within 180 days Of issuance,or If the
work is suspended for more than 180 days, ATTENTION:
Phone Phone: 503.615.5664 Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Ree6: LIC 125633 forth in OAR 952.001-0010 through 952.001-0080. You
may obtain copies of these rules or direct qunstlons to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, Past/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Sprinkler Final
Grading Inspection Post/Beam Mechanlca Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final
Fooling Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Mechanical Final
Foundatlon lnW Footing/Foundation Dr; Electrical Rough In Gas Line Insp Sprinkler Rough-in��P FI
Issued By : Permittee Signature : �.�Q , —
i
Call (503) 63-9-4175 by 7:00 p.m. for an Inspection needed the next business day
CITE' OF TIGARD i SE WERCONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00122
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/20/02
SITE ADDRESS; 14202 SW 132ND TERR PARCEL: 2S109AB-09200
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 021 _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS: 1
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF
Owner:
PALACE HOMES INC _—_FEES_
27975 SW COX ROAD F;PRMT
e By Date — Amount Receipt
t
COLTON, OR 97017 CTR 3/20/02 $2,300.00 2.7200200000
P CTR 3/20/02 $35.00 27200200000
Phone: 503-816-5664 _
Total $2,335.00
Contractor:
Phone:
Reg#:
Required inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The pen-nit 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' Perm
by: 'lssue� G it �k X11 _L¢ Per Siy►iature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day --
Building Permit A ppfimtaop
City of 'ikwdl Dakreceivrd: 3 A02ndt '.: I .
Address: 13125 SW Hall Blvd,Tigard,OR 97223 �U!PPl'no.: Expuedate:
City arTl�ard \
Phone: (503) 639-4171 Data WWW: By: Receipt no.:
Fax: (503) 598-1960 �.
A L
Care file no.: Payment type
L.arid use approval: -_ _—__ 1&.2 fsemily:Si nple Complex: t
jtl dt 2 fsmily dwelling or accessou' U Conunetrialfiedustnal U Multi-family IwNcw c mgrucdon U Demolition
O AdMorWalteratimtreowenient U Tenant imMvt nxu U Nur Vdakledalarm U Odw.
Job address: - ('r. Bldg.no, SmW 00.:
Lot ,'{ j Block Sgbdlvieion: pat:3 ���►a Tax tax lWaccount no.: `
_Fh4ect Sam:
Description and location of wort on ptenusedspecial coalitions:
Name: o. S. C�altS�nC
mailinsaddress: o —�
c�--..— II d t 6rty dwdiw.
o U�-e•. 9 daP valasti m of welds....................................... $ $ ?b
- _
. beaooa�albathe................................. —
�"...":' M Tow tst>I I
"�V •$�- .. ams..........................New dwWWg.WW4@9.f.) ........................
S.S�
t tMrnyeloeirport l9q.IQ......................... l 4•
Name: `��.t� a�S 0.b • i Coverod porch area(sq.ft.) ........................ !J _
l� Mrtiling address: De rA area(eq.M)........................................
Oder tuutxure Yea
C1 dembidholddValuation of worts........................................ t
Existing bid area 1t
lAteinaaa Deme: Sa-�t f CX1% C.b W >; (� ) ..........................
A/�eaa - New bW&areas(sq.ft.).............................
S ---- Number of varier......................................Cky:
� P6oac: _�...�� Faxesmail: Type of Goruuttctlaa....................................
_--- -
Occupancy grarp(s). Existing:
CCB no.:
( New:Cky/mmo tic,tato.:
`^ r&lWmwd
coetraetors and subt�orttrscton err eegttired tx,be
th the Oregon Construction Contrwcsms Bond under
}fie mr 04?S r n fORS 701 acrd may be required to he Ikxaw�d in the
where wort is beins perfarmed. If the applicant is
'3trae: ZIP: g..7 o enemp frau hcenidiiP.the following mason&*let:
Fax. B-Mw:
;=Addrm!
Peat date upon spOicaWm .........................�l (O,l" tante n%xived:
Cky:r1 o r T l o State: rzT1P '7 a((o AmouN received .........................I............... S.
Plfroeae �� Pax �s�!G / B-OtMI: Ple�eae eater b fee rrlredula
1 hereby certify 1 have read wd eandned this eppiiestion sod the me s IaNP as*Conk M—ad lin ora WMMW W
attached checklist.All prvvi o Uftmd oediggp=governing this U vtra O AlumC and
watt willbe oampibd w e a ex rot anew Cod 6006W
Rha+rams: C t�r a�_ .- — 3
WARM Tbie permit swiartim earpitea If a peanak it trot abodow wM6is 180 days alter k hes bow aoaepaed ae compiew woerorten
r
r ,
1 lumbi ng P'eratit Applleation
City of 'Fig'am Datereceived: Permit no.:
Addrese: 13125'W Hall Blvd,Tigard,OR 9722.1 SewerPernut W. _ Building permit no.:
City cj77gard Phone: 5U? 639-4171 Pro' tl I no
f ) !a +tpP Expircdate:
Fax: (503) .598 1960 — '
Date isstted: By Receipt no.:
Lmid use approval: —`__ Case file no.. Payment type:
"1 & ly dwelling or accessory G Commerci�ndustrial U Muiti-family U Tenant improvement
uction U Addition/alterationlreplacernew U Food service U(Aber:
EMIMIROIRW
Jab address: el
yvI�j c>)n c t 1.Yf. I to es. Total
Bldg.no Suite no.: — ---- New -� " y#"enk�only:
Tanmap/tax lot account
_ �_-- (4ts;lts/es IS**-for teadi stMv coetaect!")
, no _ _ _ —— -- — SFR(I)hath
—
I,ot: _ Block: Suixlivisioo: a SFR(2)bath
Krowt name: _ _ SFR(3)bath - — - --
City/county: _ LIP. - Ach conal bath/ 'schen - `--- -
Description and locati(xi of work on premise-1: Sketslllu":
Caich basin/ama drain
-Est.deft of completion/inspection. - - well each i trench tarn
Tooting drain(no.lin.IG) -
;Riun
ufactured home utiltiles - -Business nun..name. ' ,�)rte" �drsin
Address _ connector
City: ( + Vc_ Slate:
Zip: Saai sewet(na.tin.fl.) - --
Phone: _ Fax. E-mail: Storm sewer(no.lin.R.) _
C(B�.: 32(p04umb.btu.rt8.no:34 _ O Water service(no.lin. t.) `--
f`it /metro lic.no.: _ Fhtstreor kew
Contraaoes�esentative signature: on valve
ac ow venter
Prim none: ,.TE; Dde: Backwater valve
IIIEWINIKIN Batin& av ' �--
Name: Pp_�G.rr Ciothes waslie -
Address: c)7 9 -7 x � DishwasFrer -
t�inlcin
_city: [•rfmmtain(6j
�l}.� .__.� -- i _ scare:p�, zrn: 9 )o
E'cctota/atun
Phone;6a� (v-5W Fax:_103- - E-mail: st --
on
_Fixtureloewer cam - --
Name(print): kk&u- E%V'Y Fix dnuns/f loon sink.-%Ituh- - -
Maiai address: 4 ' Cox R Garbitge disposal
Hose bibb
City:OL,I{ i\ State: 7,1 P: JIce mAer
Phone: iSSllr S trG� Face: .� t pq Email: Intence
Owner insttdlation/residential maintenance only: The wttul installation Primer(s) --will he mark by me or the mai and repair crude by my regular Roof drain(commercial) —
employee on the propert a1n00447. ink(s), in(s), ays(s)
Owner's s `� Date: _� Sump
-
Tubs/Ntower/shower
Ntune: rival -
- - -- sten c osel
Addmas: S fz J GSL —
ater er
City: State: Zip:
��_ outer.
Phone: Faxp E-mail: jr
riot A IN 1 -tar NWW asap cads.Fkaw cam pts&om to om hien om Minimum fee................S
Notice:This permit application
U Visa U Mastercard expires if a ptxruit is not obtained Man review(al — %) S
(*M aM ww6w ---I----- within ISO days alter it has been State surcharge(8%)....S
_N�7 mag cN&co ' occepted as cmp".ete. TOTAI. .......................S _
i
Asap
404616 trvaatnMt
Electrical Permit Application
Date received: Permit no.:
City of Tigard Project/appl.no.: latpire datc.
C av of Bard Address. 13125 SW Hall Blvd,'Tigard,OR 97223 Date issued: By Receipt no.
Mone: (503) 639-4171 - --
1,ax: (503) 598 191)0 Case file no.: Payment typei
Land use approval:
Irl 2 family dwelling or accessory U Commercial/induc,rial U Multi-family U Tenant Improvement
.New construction U Addition/allern ioWreplacemcn. O(filter. U Pattiai
6
Job address: i l yl Bldg.no.: Suite no.: 11ax map/tax lot/account no.: _
I cu: Block: Subdivision: 1999O �
Project name: _ — I Ekscription turd location o ork on premises:
Estimated date of com ledon/ins c.uon-
Job tae: Rhe Mia
ea) Tout oo.lnsL
Business name: t` L Newradi� aalagFawrmatl�faaelf�
Address: (.tq 0✓) I � �
City:T state: . 7 a 1 Ssvlceb ow f
Phone: _Sib Fax: E-mail: 1000 fl.c leas _a
CCB no.: yU Elec.bus.tic.no: _ C Bach additional foo mg h-or portion thereof
Wilted enny,residential 2
Cit /metro lic.no.: United energy.noir-rokkintial 2
Bach manufadue F mor modular dwelling
She of atpaviaing etaxtrician(reqs ired) pate - Service cuVot feeder 2
Sup elea.naroe(print) -- Ueatseno Sevieworfenlers-brtatbmdoa,
alteration w mloe stiew
HimmaLmaws 1 l 200 amps or kgs 2
Name( t): i.t.ht-C-1-�►a ` tot amps to 400 amp. 2
Motilin address: 401 amps to 600 amps _- _
Mailing j �t 7�> >_ 6'0l to 1000 no 2
Cit : 1 State: 71P:'M/ over 1000 snip of volts 2
Phone: yj le. '(oc.*y 1 Fax: 3D 30'j 1 15-miail: Reconnect only i
Owner installation:71te installation is being made on property I own Tempwary aaervlen or females-
which is not intended for sale,lease,rent,or exchange according to boaWsoloWshunedWer'elevatka
URS 447,455,479,670,701. gnu amps in leas -- 2
201aoVs to 400 2
"Nam: '
' tre: Date: 401 to 600 ams y 2
IMMUNE MUwb rbYds-trmw,alters Iles.
1 W 4rst�a par PUM:
4"1 %Z 0 0) 3f_, Fee fns hranch circuits with purchase of
At1dff.a' a: < <�C 1 r t C1 service or feeder fee,each branch circuit 2
City: Id� R Fee lot branch ciranu wittow purchase
Phone:,5y-�A,y Fax:, -t,,7E mWl: at advice or reads fee.fins branch cun_tit 2
bath additional mich dreuir
MIK.(9ervkew astioctded):
U Service mar 225 ampa•aonea dal Cl Health-carehcility t!"pump or itrigatlott tide _
�(Saviex over 320 amps-)ming of I A 2 U 1I1wdous locnlnn Bach air or outline Iighuun - 2
Gtnily dwellings l l lluihfing ova)IrJ,ll(I(I square toes foe)cs Signal circuit(s)or a limned energy prowl, —
U Syswm over 600 vole nomanal nure residential onus in nese atru<yure altamion,aextension• -- -- 2
U AuilAing tiler duce ahurita U lereden,400 amp of iron •t)eKri on
U lkcvpwx land over W pinna n s U Mrnufwurrd strwimrs nt RV park Fweb adrM1laW l I ever dw eNOwSW is My el rhe-aabeNe
U lgirrss/lighrrtagplan U(Idler ---- Per
9araaM�-_-alta of plea wkb stay of the above. Invtytigwoo fee
Ile abnre are am appUcsW to tcupwwry caaatrtcilm stertor
me as}tlsaieaaa WnW craft atilaaa t,pbtea Jlatadtetlt•ter alta ldaarala.. Notice:This permit appimmion Permit fee....
U Visa U MaataCard expires if a permit is not obtained Plan review(at
i S
rival cod server _ _ ----L._/__ within 190 days after it has been State surcharge(8%)
accepted as complete TOTAL ................
armor n thowo ata -
3 _
-__.raidMM�a d/rwwa - AsoaM - 4*-O 1*1516MV0M1
,1
MeMechanicalPerra�it Application 5 -
- Datereceived: Parmit W.:
City Of Tigard PM)Myappl.no.: Expire date: —
City,,f-ngard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Due issued: By: Rccciptno.:
Fax: (503) 598-1960 raw filen.: Paymenitype
Land use approval: BuiWingpcmitnc.:
1 &2 family dwelling or accessory U Commercial/industrial u Multi-family U Tenant improvement
New conanie ion O Addition/alteration/mplacement U .)thea.
Job address: q 2 c,L VICI Ttlr ,, Indicate equipment quantities to boxes below Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor.overrivad,
Tax mapit x lodac mnt no: profit.value$ - -
Lot: j JBIt,ck: Subdivision. (,n'�� 'Sae chtxJtlist for important application information and
Project n.urte: jurisdiction's fee sche4ule for residential permit fee.
City/county:
Descripliat and location of work on premises: -_
_ Fee(ea.) Tam
Eat..date of empletion/inspection: Qty. Res. Ras
Tenant improverne it or change of use: 7._4-1fW_QifioninJ(%i1e
Is existing space heated or conditioned?U Yes v Noit CFMR�Mln
Is existing space insulated?U Yes U Nc �'—� extatia —�
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”"'•� BY PALACE )COMES INC
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WEBER ELECTRIC INC
PO BOX 231154
TIGARD, OR 97281
Electrical Signature Form
Permit #: MST2002-00171
Date Issued. 3120/02
Parcel: 2S109AB-09200
Site Address: 14202 SW 132ND TERR
Subdivision: RAVEN RIDGE
Block: Lot: 021
,Jurisdiction: TIG
Zoning: R-7
Remarks: S/F Path 1 KEEP FIRE SPRINKLER PLAN WITH MASTER PLAN
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-
PALACE HOMES INC WEBER ELECTRIC INC
27975 SW COX ROAD PO BOX 231154
COL T ON, OR 970 17 TIGARD, OR 972811
Phone #: 503-816-5664 Phone #.
Req #: LIC 44087
SUP 4028s
CLE 34-442c
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: FLM2002-00092
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/02
SITE ADDRESS: 14202 SW 132ND TERR PARCEL: 2S109AB-09200
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 021 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 20 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of approximately 20' sewer line.
_
Owner: — --- —
Type By Date FEESAmountReceipt
PALACE HOMES INC
2.7975 SW COX ROAD PRMT CTR 3/18/02 x/2.50 27200200000
COLTON, OR 97017 5PCT CTR 3/18/02_ $5.80 27200200000
Total $76.30
Phone 1: 503-816-5664
Contractor:
PALACE HOMES
2797E S COX RQ
COLTON, OR 97017
REQUIRED INSPECTIONS
Phone 1: 503-816-5664 Sewer Inspection
Reg #: LIC 125833 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicab:;: laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follo%,v rules adopted by the Oregon Utility
Notification Center. 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 co OUNC by calling (503) 2.46-1987..*
Issued By: Permittee Signature:,% <<,
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbing Permit Application
City Of Tigard Datcreceived: 4 op Permit no.: L
Address: 131253W Hall blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
City of Tigard phone: (503) 639-41"1 Pro'ect/a) I.no.:
,. 1 1 P Expire daft:
Fax: (503)598-1960 �,fr jpp GC l7
Date issued:_ By; Receipt no.:
Land USC approval: - Case Glc no. Payment type:
1
Xc 2 family dwelling or accessory U Commercial/industrial UMulti-famil
New construction U Addition/alteratior/replicement U Food ser7lice U Tenant improvement
U Other:
EMPLII;LlymFIT'71M1
1I
_Job address: /�%��c� $(,� i"`
_ Descripflon (pfv. Fee(ea.) 'Total
Bldg.no.: Suite no.: New I-and 2-family dwellings on-,:
Tax map/tax lot/account no.: --- --- (includes IOOR.foreachutility connect ion)
Lot: I Block: Suion: ---_- SFR(1)bath
v' FR
Project name: �, - - S (2) a
--
City/county: 71p: � _ SF7t(3)bath
Each --
additional tiath/kitchen ---
Description and location of work on premises: Siteutilltles:
Catch basin/arca drain
Est.date of completion/inspection: - D wells/leach lin-/trench drain —
1 Footing drain(no. lin. ft.) -
Business name: Manufactured home utilities -- - -
< < , � y►� C - Manholes
EE
Address: - - --
Rain drain connector —
City: State: 'LIP: Sanitary sewer(no, lin.fFax: E-mail: Storm sewer(no.lin. ft.) --
CCB na.: Plurnb,bus.reg,no: Witter service(no. lin. ft.) —'—
City/metro lic.no.: - Fixture or Item:
Contractor's representative signature Absorption valve
Print name: — Back flow reventer -
1 Backwater valve
Basins/lavatory --
Name: - Clothes washer -
Address: _- Dishwasher -
City:_ -- State: LIP -- Drinking fountain(sj _ --
-�-- Fax:
E-mail: - - E'cctors/sump --
Expansion tank_
Fixturc/sewcr cap
Nantr{print): _ _ hIWr drafns/floor sinks- - —
Mailing address; -- -- (3arhagc disposal --
City: --- - - Slate:— LIP: Hose hrbb --
Phone: -----__ Icc maker
Fax --
: 1 E-mail: Intcrt a tor/ rcnse tea
Owner installation/residential maintenance onl 1 he actual installation _2
will be made by me or the maintenance and repair made.b m re 11lar Primer(s) —
em to ee on Ute property I own a� ORS p y Y R Rtx)f drain(commercial) — -
P Y' I Ix I>Lr RS f'haplcrate: Sin c(s), asin(s),lav—s(s)
— -
Owner's signature: Dote: — Sung_ — - - —
Tubs/shower/shower pan ---
Name: WateD 4 < � U-Fe r
Address: r closet ''- ---
City:
_ _ State: LIP: Water heater —
Phone: Uthcr.
Fax: E-mail: oral
Not all Juridictlrxu accept ctrdit code,pteae cell Jurl.allctlta rut mmr wrnrra.lion. Minimum fee................$
U Visa U MasterCard Notice:Phis pern)it application
Credit cord number: expires it's permit is not obtained Plan review(at — %) $
-`-- — s�- within 180 days after it has been Stale surcharge(8%)....$ '�-�—�U�
Name trf c order u shown rm credo crd accepted as complete. TOTAL .......................$ —5— F)
Cart alder oiartatum r
"GA16(140 rom)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES (individual) pTY mea AMOUNT (includes all plumbing fixtures in PRICE TOTAL_
Sir,k 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory -^-- 16.60 for each utility connection)_
One(1)bath $24920
Tub or Tub/Shower Comb -- 16.60 -Two(2)bath ---- $350.00 _
Shnwer Only 1660 Three 3)bath $399.00 _
Water Closet - 16.60
_
Urinal - 16.60 SUBTOTAL— — 8%STATE SURCHARGE _
Dishwasher --i 1660 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 1660 l_.-___— __TOTAL -
Laundry Tray — 16.60
Washing Mach ne 16.60
Floor Drairifluor Sink 16.60
3° -- 1-6.60 - PLEASE COMPLETE:
4" 1660 _
Water Heater O conversion O like kind 16.60 — Y Quantit b Work Performed _
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
hermit
MFG Home New Water Service 46.40 Sink__
MFG Home New San/Sloan Sewer 4640 Lavatory-�—
Hose Bibs - 16,60 ----- Tub or Tub/Shower
_ Combination
Roof Drains — 16.60 Shower Only -
Drinking Fountain 1660 -- Water Closet
Other Fixtures(Specify) 16.60 _ --- Urinal --
--- _ Dishwasher
varba a Disposal _
Laundry Room Tray
--- - `— _W_ashi_n Machine -
Floor Drain/Sink: 2"
Sewer-1st 100' ------- -- 55.00 - 3"
Sewer
-- — ---
Sewer-each additional 100' 4640 4^ — -
Water Service-1st 100' 55,00 - Water Heater_— _
Water Sep
rvice-each additional 200' 46.40 (Ser Fixtures
S ecity)
Storm$Rain Drain-1st 100' 55.00 - --
Storm&Rpin Drain-each additional 100' - 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 -- -
Catch Basin --- - 16.60 --- ---- -- — ----
Inspection of Existing Plumbing or Specially 62,50 Rogues ed Inspections _ per/hr COMMENTS REGARDING ABOVE-
Haiti Drain,mingle family dwelling 65.25
Grease Traps - - 16.60
------ QUANTITY TOTAL - ----- -- -
Isometric or riser diagram Is required 1f — — — - --
_—
Quantity Total I >g -__-- ----------_--- —_— --
'SUBTOTAL --- - - - - -- -----
---- ------- --
------ ---------- ---- --
8°:STATE—SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL
— Required only If nxturrI total Is`g — —
TOTAL - a
Minimum permit fee is$72 50#656 stale surcharge except Residential Backflow
Prevention Device,which Is$36 25+8%stale surcharge
"All New Commercial Buildings require 7 sets of plans with Isometric or riser
diagram for plan review.
1ldsts\forms\plin-fees doc 12/26/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
Received Date RequestedBUP
!.ocation /4,/ ?C) 2 r -- - - - AM----- — PM-_ - SUP
Contact Person _ -- MEC
Contractor - _-)_Suite------ -- -- PLM ZQI2 -CU07L
----------____ -- - Ph(---) ---
BUILDING Tenant/Owner SWR
Foot --- -
ing - - - -- — ELC
Foundation -- - -
Ftg Drain Access: ELC _
Crawl Drain ELR _
Slab Inspection Notes: — -
Post R Beam SIT _
Shear Anchors - - - --
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - -
Firewall
- - - -
Fire Sprinkler
Fire Alarm -- -
Susp'd Ceiling - -- - -
Roof
Other. - - - -
-- - - -
Final - - -
PASSFART FAIL
PLUMB_ING _
Under Slab
Rough-In
Water Service
Sanitary Sewer - -
Rain Drains -- _
Catch Basin/Manhole
Storm Drain -
Shower Pan -
1Ll@r:
PART FAIL - - - - --
-MECHANICAL -- -- -
Post& Beam --
Rough-In _
Gas Line
Smoke Dampers
Final
PASS PART_ FAIL --
ELECTRICAL - -
Service -
Rough-In
I.IG/Slab - ----
Low Voltage - -.
Fire Alarm - -`------- -----
Final
PASS PART FAIL -� Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE—� __ Please call for reinspection RE:__
Fire Supply Line -- F] Unable to Inspect-no access
ADA p
Approach/Sidewalk Date 3 0 2 Inspectors
Other.
Final DO N01 REMOVE this Inspection record from the Job site.
PASS PART FAIL.