11245 SW 84TH AVENUE I
I�
11245 SW 84t" Avenue
CITY OF -TICaARD 24-dour
BUiLDING Inspection Une: (503) 639-4175
INSPECTION rh!1.1:SIhN MST
t3usiness line: (503) 639-4171 - -
BUP _
Received Date Requested_ AM— - __PM BUP - -_
Location f L �2 _4._�; Suit, MEC
Contact Person Ph( — ) i W pLM
Contractor _ -- Ph( ) --_-- SWR - -
BUILDING Tenant/Owner — __- - _ _ ELC
Footing ------ ELC _
Foundation Access --
Fig Drain E ELR
Crawl Drain
Slab Inspection Notes: ;SIT
Post&Beam __—_ --_----- _
Shear Anchors �— — -- -
Ext Sheath/Shear
Int Sheath/Shear — —
Framing - - --- ------- —. — — —
Insulation
Drywall Nailing - - -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
' Rain Drains ----- -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Ina
SS PART FAIL
NICAL
Post&Beam
Rough-In _
Gas Line
Smoke Dampers ----------- ------------- — _—. —_—.—__ —_ _
Final
PASS PART FAIL
ELECTRICAL
Servico
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinapection fee of$_ — required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL_
SITE [� Please call for reinspection fry Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date �7=1 z_.____.,__ Irnfal)ocior _ �y-' _ --Ld _—_-_—
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST .ZJ%� 3
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _�. 1_� Date Requested ' — AM PM —_ BUP
Location Suite --__ MEC _—
Contact Person _ _— Ph(_ ) — PLM
Contractor_ __ Ph( ) �' // SWR
BUILCING '1 Tcnart'Owner 1 -' —La_�t�L_— EL C
Footing ELC
Foundatiun Access:
Ftg Drain �. ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear.Anchors �-
Ext Sheath/Shear �-
Int Sheath/Shear
Framing - - ---- -- ---- --------
insulation
Dr;v.dil Nailing --�- -
rirewall
Fire Sprinkler ---- - ------
Fire Alarm _
Susp'd Ceiling - --- __ -
Root
Other: _. —.--�--------- - -- --- — —
Final
PASS PART FAIL ---i -- --�--- - i--- --
PLUMBING —
Post&Beam
Under Slab --
Rough-In
Water Service ---- ---- -- --
Sanitary Sewer
Rain,Drains _...----- -------- - --- --
Catch Basin/Manhole
Storm Drain --
Shower Pan
Other: ----
Final -- -----P -----
PASS ART FAIL
-- SS PAIRT
MECHANICAL --
Post& Beam
Rough-In -- ---- - ---- —
Gas Line
Smoke Dampers --
Final
PASS PART FAIL _—._—
ELECTRICAL __ --- ------ - — _ — —_— - -
Service
Ru,igh-In
UG/Slab
LowVnitage
Fire Alarm — -
ASS P/�R'� FgIL F] Reinspoction fee of$ _ ._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
�_—_
Please call for reinspection RE: _ ___ .— Unable to inspect-no access
Fire Suppl o Line ((�
ADA xt
�� cJ s2" 4. /t'�-!l E __.
Approach/Sidewalk r
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARC 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received _ _Date Requested __ St_,�,.� AM_______PM __ BUP _
Location _�LL�'�Li �,. 7 _9� Suite_ MI:C
Contact Person Ph( ) `t J T� PLM
Contractor_ — - Ph(—) __ S1i11R
BUILDING Tenant/Owner _- ELC
i'oc ging ELC — —
F wi dation Access:
FY Drain ELR
Crawl Drain SIT
SlaL Inspection Notes:
Post&Beam ---- -- -- - —— — -
Shear Anchors
Ext S.ieath/Shear -----
Int Sheath/Shear
Framing
Insulation
C'rywai:Nailing —
Firewall —
rire Sprinkler --------__-__- --. _--------------- -- —
Fire Alarm --
Susp'd Ceiling —
Roof —
Other:—
4r�ii
- — ---
�jp
PART_ FAIL_
PLUMBING ___----
Post& Beam --
Under Slab ---
Rough-In
Water Service --
Sanitary Sewer
Rain Drains -- -- - - -� —
Catch Basin/Manhole
Storm Drain --------- _ — -
Shower Pan —
Other.
Final _ —_--- ---_--.—___
PASS PART FAIL
_
MECH_A_NICAL
Post&Beam
Rough-In ----- ------- - _— _
Gas Line
Smoke Dampers -- -
Final
PASS PART FAIL -- — ---- - —
ELECTRICAL _--
Service
Rough-In
UG/Slab
Low Voltage ---
Fire Alarm
Final Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line _
ADA Date �j" – "�___ Ihspoetor
Approach/Sidowalk
Other: .
Final - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
�LAAAA A AAAA Aee.♦sAAeAAAAAAAAAAAAAAAAAAAAAA,&.Ai
CTl I✓ cn ►
Ar9 0
Qh
y ►
= ►
P d ►
N �s � ° ►
d Co
a n POO.
�' `` ►
C ► o
7 v4 (pol.
p—
� � C
ON.
t '1 rD ° P'
p rQ y ►
crQ
►
►
p
y ►
rvvvvvvvvvvvvvvTvvvvvvvvvvvvvvvvvvvvvvvvvvvvI
i ® i
i ►
t R
�I ►
43
co
CL 5
eo
e �
a
co�
o ?
� t
0
rz
� a ^
f rp
a � �
o
o � �
� � n
0
'a'
CITY OF TIGARD -
PLUMBING PERMIT
DEVELOPMENT SERVICES FERMIT#: PLM2002-00156
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 5/8;02
SITE ADDRESS: 11245 SW 84TH AVE
PARCEL: 1 S136CI3-10700
SUBDIVISION: ASH CREEK MEADOWS "ZONING: R-12
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORE: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
'TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP': R3 FLOOR DRAINS; TRAF :j:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAVS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURE`;:
i�'!?/SHOWERS: SEWER LINE: it
WATER C:Lv=TS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of backflow preventer.
--.__---
Owner: FEES
—
Type By Date Amount Receipt
ESLINGER BUILDERS INC
11575 SW PACIFIC HWY. PRMT CTR 5/8/02 $36.25 27200200000
PMB 160 5PCT CTR 5/8/02 $2.90 277.00200000
TIGARD, OR 97223 Total $39.15
Phone 1: 503-620-9515
Cor tractor:
ALL OREGON LANDSCAPE INC
85"5 SW SOROENTO RD
REAVERTON, OR 97008 REQUIRED INSPECTIONS
RP/Backflow Preventer v
Phone 1: 646-6426
Reg #: LIC 6667 Final Inspection
This permit is issued subject to the -Qqulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work iF, not started within 180 days of issuance, or I work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Cernar. 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 to COUNC by calling (503) 248-1987,
i
Issuer♦ By: .�t�. ZL 't-� Permittee Signature:
Call (503) 639-4175 by 7:00 P,M. for an Inspection needed the next bq* ness day
i
Plumbing Permit Application
- -/ Date received: � d� Permit no.: - I71,aI:�p,'� �
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By:74t Receiptno.:
Land use approval: Case file no.: Payment type:
U 1 &2 family dwelling or accessory U Commercial1industrial Le Multi-family U Tenant improvement
New construction U Addition/alteration/replacemcnt U food ser-ice J Other:
JOB SI'I L IN FM(MA'I]ON FLYSVLE(fors0eclafinforruallon use checklist)
UIED
Job address: S / 1)CtiCrlph—I _ Qty. 1•ee(ea.) Total
Bldg.no.: Suite no.: New 1-and 2-family dncllinR.only:
Tax ma /taxlot/accountno._ (Includes 100ft.forrac•hutilitycnnnccrionl
p _ SFR(1)bath _
Lot: I Block: Subdivision: SFR(2)bath
Project name: SFR(3)bath _
City/county: ZIP: Each additional bath/kitchen
Description and location of work on premises:_ __ Siteutilkties:
T , i�ic e Catch basin/area drain
Est.date of completion/inspection: Drywells/leach line/trench drain
Footing drain(no.lin.ft.) _
Manufactured home utilities
Business name: die tom. L -C. Manholes
Address; jr5-74{ :5vppEhIV fucF U Rain drain connector
City:_ 3 "C4'q4 _ j Slate:Bl. ZIP: 7CZ7 Sanitary sewer(nn.lin.ft.) —
Phone �>3 fe'A/(,"-�y,, Fax: S?5 — E-mrli1: Storm sewer(no.tin.ft.)
Water service(no.lin.ft.) --
CCB no.: — Plumb.hu .reg.no: /r
Fixture or k
t-
City/metro lie.no.: hm:
Abso tion-alve
Contractor's representative signature: Back t ow preventer _
Print name: '1..Pf7 6 Prew Date: Backwater valve
Basins/lavato _ —__—
Name: Clothes washer —_
Dishwasher _
Address: — Drinking fountain(s)
Cityv _ State: E•ectors/sum
Phone: Fix: E-mail: Ex anion tank
Fixture/sewer ca _ Y _
Name(print): I r 41 �j —Floor drains/floor sinks/hub _
- Garbage dis"oral
Mailing address: r( jvv l 'Cc Hose Bibb -- ----
C'ity: T') CG^ C v ''j7 L State: ZIP: re maker
Phone: `/c- '` Fax: E-mail: Interco tor/ rcase trap
Owner instal lation/residential maintenance only: The actual installation Primer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),hasin(s),lays(s) _
Owner's signature: Date: _ Sum
Tubs/shower/shower pan
Urinal - - - --
Name: _ — -- Water closet —
Address: Water Fcater
City: State: ZIP: M_ O er:
Phone: Fnx: _ E-mail Total _
Not at' Aidicnom wceo credll cards,slew call)urlsdicuon for more Information. Notice:This permit application Minimum fee................
tWiea O MasterCard expires if a permit is not obtained Plan review(at u %) S _—
Creast card numbs within 180 days after it has been Slate surcharge(8%)....$
x Irca
rlune of crdh'-Ter as aMnvn on iiWit card
accepted m complete. TOTAL .......................
f
Amount ")14161MXYCOMI
PLUMBING PERMIT FEES:
- -
FAZE TOTAL New 1 and 2-family dwellings only: i
FIXTURES individual QTY (ea)__ AMOUNT (includes all plumbing 7ixtures In PRICE TOTAL
-Sink 16.60 the dwelling and the first100 ft, QTY (aa) AMOUNT
for each utility connection`
Lavatory 16,60
-_ -- _- -- One(1)bath - $249.20
Tub or Tub/Shower- Comb 16.60 Two 2 bath $350.00
Shower Only - -- 16.60 Three(3)bath _ ---$399.00
Water Closet 18.60 SUBTOTAL _
Urinal - 16.60 8%STATE SURCHARGE _ T_
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 -__ TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
- PLEASE ICGMF'9.ETE:
3" 16,60
4" - 16.60
Water Heater O conversion O like kind 16.60 _ Quantity b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. - Ca�Ped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sower 46.40 Tub orr
. Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures(Specify) 16,80 _.
_ ( p "�') Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine _
Floor Drain/Sink: 2"
Sewer-1st 100' 55.00 3^
Sewer ach additional 100' 46.40 4"
Water Service-1 a 100' 55.00 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
S eci _
Storm&Rain Drain-1st 100' 55.00
Storm&Rain Drain-each additional 100' 46.40 --
Commorciai Back Flow Prevention De,tice 46.40 -
Residential Backnow Prevention Device' 27.55 -
Catch Basin 16.60 _
Inspection of Existing Plumbing or Specially 62.50
Re ueat,1d Inspectionsper/hr COMMENTS REGARDING ABOVc�;
Rain Drain,single family dwelling 65.25
Grease Traps 16.60 - -
QUANTITY TOTAL
Isometric or riser diaoram Is required If
Quantity Total Is >6 _ -
*SUBTOTAL
8%STATE SURCHARGE - - -
"PLAN REVIEW 2F%OF SUBTOTAL
Required only It fiXture qty total Is>a
TOTAL 5
Minimum psimlt fee Is$72.50•a',,.%Ote surcharge,except Residential Backflow
Prevention Device,which le$30 25 4 s%state surcharge
"All Now Commeralel Buildings require 2 tits of plans with Isometric or riser
diagram for plan review,
1.\dstsHuimslpim-fees.doc 12/26/01
CITY OF TIGARD __ MASTER PERMIT'
PERMIT#: MST2001-00563
DEVELOPMENT SERVICES DATE ISSUED: 12/31/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 11245 SW 84TH AVE PARCEL: 1S136CB-ACM11
SUBDIVISION: ASH CREEK MEADOWS ZONING: R-12
BLOCK: LOT: 011 JURISF)IC'TION: TIG
REMARKS: New SF detached residence. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 709 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 905 of GARAGE: 413 sf FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 F:NBSMENT: 6f RIGHT: 10
VALUE: S 156.057.80
OCCUPANCY GRP: R3 BDRM: 3 PATH: TOTAL: 1,61400 sf REAR: 19
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 2 GARBAGE DISP: 1 WATER HE,`TERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
rUEL TYPES FURN<10OK: 1 BOIL/CMP<]HP: FENT FANS: 4 CL t.•MES DRYER: 1
GAS '— FURN>•100K: UNIT HEATERS: HOOUS: 1 OTHER UNITS: 1
MAX INP. btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIaENTIAL UNIT SERVICE FEEDER ERVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: W/SVC OR FDR: 1 PUMPIIRRIGAVON: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: 1st WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EA ADDL BR CIW SIGNAL/PANEL: IN PLANT:
MANU HM/SVC/FDR: 601 • 1000 amp: 601+amp9•1000v: MINOR LABEL:
1000♦amp/volt
PLAN REVIEW SECTION
Rscnnnect only:
>•4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREIVSPC OC4
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B,COMMERCIAL
AUDIO B STEREO: VACt M SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,936.32
This permit is subject to the regulations contained In the
ESLINGER BUILDERS INC ESLINGER BUILDERS INC Tigard Municipal Code,State of OR. Specialty Codes and
11575 SW PACIFIC HWY, 11575 SW PACIFIC HWY all other applicable laws. All work will be done in
PMB160 TIGARD,OR 97223 accordance with approved plans. This penult will expired
TIGARD,OR 97223 work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION:
Phone: Phone Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rey N: LIC: 52363 forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechaoica PLM/Llnderfloor Electrical Rough In Gas Line Insp Water Line In1:p
Sewer Inspection Underfloor insulation Ftng Drain Bsm't Walls Framing Insp Gas Fireplace Appr/Sdwlk Insp
Foot rig Insp Crawl Drain/Backwater Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final
Foul lalion Insp Footing/Foundation Dr; Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Mechanical Final
PosUE,-am Structural Pim/undslab Insp Electrical Service Low Voltage Rain drain Insp Plumb Final
G� .0 Permittee Signature : `
Issued By : �� � 9 A—,
Call
'
Call (503) 6313 75 by 7:00 p.m. for an Inspection needed the next business day `
CITYOF TIG R D SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SINR2001-00316
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DkTE ISSUED: 12/31/01
SITE ADDRESS; 11245 :.W 84TH AVE PARCEL: 1S136CB-ACM1,
SUBDIVISION: ASH CREEK MEADOWS ZONING: R-12
BLOCK: LOT: 011 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL. TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SF residenc(:
Owner: -- — -
-- _ FEES
ESLINGER BUILDERS INC Type By Date Amount Receipt
11575 SW PACIFIC HWN'.
PMB160 INSP CTR 12/31/01 $35.00 27200100000
TIGARD, OR 97223 PRMT CTR 12/31/01 $2,300.00 27200100000
Phone: 503-620-9515 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
This Applicant agrees to comply with all the rules and regulations 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 t�ie 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
Issued by: ,, lt- le? 'L. Permittee ftnatUire: J� +p
Call (503) 09,4175 by 7:00 P.M. for an Inspection needed the next business day
Building Permit Application
City of 'Tigard -';1611 Duicreceived: I j . .0 1 Pernlil Ito.:
F' Address: 13125 SW Ilull Illvd,Tignrd,OR 97223 1110jecl/upPLnn.: pxpircdmc
r ln'11/li�;lnr1 I I I):aeissued: Il
hone: (503) 619-1171 y: '�� I Itccclpl1111.:
Vim (503) 598.1960 (;Ise lilt Ito.: I'uynlcnl type:
I..illl(I use approval: __ 1&2 fiunily:Simple C'unlplex: f�--
1
U I & 2 homily dwellinl;sir accessory LI('fifiunc.rciul/indusUial 1.1 Mulli lamily Ncw cfinsrincliun U I voimlulnn
U Addition/ullcluliunhcplueenlenl U'1'enanl impmvelncnl U Dire spiinklcl/eb .. U 011ier: __•---.-�__
1 1 1
Job address: 11 ILI 5 ej W tAiT� c22.1 1111(18.no.: 3uile nfi.:
Lot: 1! llluck: �Sohdivision: �� (�rPl!- n{f�C)rr�Otr1r�'1'ax map/Ulx 1111/nccounhw_:� � ,
I'm ccs llnnle:
Description um' '•tcillion of work 1111 pre III ises/spec!III conditions: 6�,1 �[
1 1 1
if
Name: LEI �!'1C�_l0
Mailing address:1/_ U '' � �1,1 •({ ' � (.rU(—y�+�/l ] ��jj1 1 &2 fnml11y dwcllln(;:/ G Z Z�' N d
City: � � 51n1e: 1.1111" '/
' y' �L��.Sr � .��_� �li��,�.� V+dunlictn ul wink..........7............................ 9�
I'hfinc: �I'ilx'G 7 1 y h nulil: Na.of liediOmw,imus.................................
Ownel's nyneseoialive: Yip et.)_m_ l� Twill 11urllbl•I 111 114 fill .................................
I'hfinc: �j I fix: µl,� fs nu►il: — Ncw dwclliug aic.i (sq. 111.) .......................... --
(ialill;ch alpoll Oren(ml It.)......................... -
N:u Iv: ('uvcicd pull II :uca(fill. fl.) ................... ..... f\ ---
/�� ` Ih1k mv;i(•, 11 ) .............
Mllnl nhhctie ( .r I ) /C I .... .. .
Illy iU11Ct 1.11'. I)11111 ',Inn Inlr :111;1 It11 II 1
I'hnne; I�ax: IS-Illnll; - -- -- ('21nnn1•I 11111/i)UIINII sal/lllfilll l:uully:
Valuetiuu of wall. .......................................CONTRACTOR
$
/ Exislini;bldg. algia(sq. fl.) ......... ... ..........
11uriness nanlc: tr.'!l�('C' ,��J�13�_✓ _ ,>�rrl�='
Anil ----- I r Ncw bldg, nrcu(sq. It.) .
Address: t, ..........".....
............
_-_ -.Y��f' C�.� ,�L! ' Numhel of simics
City: Slnlc• ZIP
_—
x - 'Type ul•construction........ ............... .. ...
Thune: fvlI?-mail: .
Occupancy groop(s): Existing:
C no.: �2_� _. _. _. _ New:
1i 11�Y!Jlv I Ifi til'. nfi : �1 Nollce: All cmilim Int'; mid%Olimi om)firs alt•. requited Ifi br
ARCUITIECTIDIESIGNER licl•nel•d wills the lhcl,un('unsrlm line Colitin11111s 11niml un11r1
Nnnlc: �• p111v1.lune Of ORS 7(11 illltl 111Ay hr 1111ni1 d lu In hrrn I d nl 1111
\1ldlcss: ' I �— -- I1m%ilu non Where wmk iH living prllulnn•11 11 Ih1 ;111111; 1
_. 1._1 ? ��tL �� I rnl 11 ImIll Iiccnshl l the lulluwill fcllsun :1 1 Ilu '..
__ r _ I I I I
Icy- '-igd'��l_ _ .,t��1
1 fi
11'11,11112111
ILM
Fl;uur h«p t I +�(t.,Yr1 ty Y. 1 nnlncl p11' 1.11. 1 \ I'1r',due upon appUe111ifin -....._
r111�1n••.•. Alt 1 S'1 r. f.1.� Lt >(�G)�_.�--_. 11111 11vvivcd.
11111 (ti1.11c I:'11 Anlnunl 1111 rvl d . ... . 1,
I'llnnc 111-.1x I I': Imill I II n I kit's lu ll.c sl Ilrllnll
I Ill'll'by 1'1'1111 y I Ilim.Aty"�"—L
It'd Illis 11114Ical lilt%illltl Ille. low sill pniwliclluat sil'rclN rwdil twill,hleUte tall p111,dn11„1,I..,.nisi..... nl,nun
imat hc11 checkhsl. Allit inunlc% povelniul;Ibis UVigil U klaticl('ald
work will be 1'Omp11P11 Is 1 cleill Ill Ilul. Ord11 ewd 111111d,v.
I.
---
--Atlllll111Ze111 S11'llalul l lie: IZ o 1 Nrn1r of tru�w'I ri thnwu untie'—"�fi�l tyiull
' I�'�l_l.� 0f .
InI 11;11nnl; C r _ _�.i'a;irl/, ;�an;la
111,111 c '1 his perinio 111,11111❑linrl cxphc%il'it pclmtiil nal ublnined wilhiu I Nil d11ys'dlct it lilt%heel►ltceepled 114 enagtlele, I n1 u,l 1 0,4140 1nn
1"11111111W11119 PCIheuit:Application
City of `I'i�,'ard T uatereceived:
I'umii no:
Address: 13125 Fly flail Blvd,Tigard,Olt 97223 Sewer pcnnit no.: Building permil no.:
CirynjTrdnrd Phone: (503) 639-4171 Pru ccda r rl.no.: ^-
j If L'xpircdalc:
Fax: (503) 598-1960
palclsauul: fly; Itccciptnn,;
I_awl USC apps-ov.11: - Case file no.: Payment lype: ---
1
U I &2 fancily dwelling or accessoly U Crnnnrc►cial/indusllial U Mul!i•famil
jlk.Ncw conslnlctioll U Additinn/atleralioll/replacenlenl U flood service U I'cuam inrlrruvcnrcrl(
U OIhcr.
t 1 1
_lob addlcss: 1 LI.I r5 tLl..
Z23 llcscrllNlon ( _ hce(c Total
rax no.: _ Suite no.: Nctr 1-and 2 faudly threllin[s cn11y:
fax moll/lax lot/accouI I no.: G �J anC� - (Includes 100 A.forexcltu11111yconnection)
l.cli: Illcx k:
-Subdivision: Spit(1)bmh
Project,rlama: ��1, ('r e e A Sf -�- `W-- Spit(2)balk
Cil /counl �"`�� Sl P(351ruh -
Y Y Tiwc.rr� rn 711' �7 )5 — .achnldtOlin l Imll%kiicren -"
Ucsc.nplloto and 1 .aliou of work on plcnlises: Slleulilltlm
-� -rte-ll�''�{ CalcIt basirt/alca drain
Ist.dale of cenrplctirnl/inslleclion: _ 1 D we I eac 1 lin UETI-6111 in -
fronling drain(no. lin. fL)
Business nnmc: OM(-- 1L,,. �}fir►.,. C Mnnufaclurccl hontc utilities -
Address: --
( Its to ran connector
Chy: �l�lt�r�l)/ _ Slntc:C ZIP:rI llqu Sol sewcr(no.lin.fl.)
1'honc:(G,�y• (hK� Fax:l,L`;•IA-A Mmail: Siormsewer(Ito. iTriR.)
M1 no.: (o' [(� Plumb.bus.rag.no: 11 ( - Water sery cc(off t(t f1
City/nte( o lic.no.: C) �- future or Item:
COMM I's mpresenlativc signahlrc: Absorption valve
[l[lack flow plcvcnler
1 1 pnckwnlcr valve
Q
Uasins/lavato
��Name;
1._L1L1 lr►( C Ol IC9 washer – --'—
Addtess` -- - _15Tsrwas i -
it �� I)iilikin f�ounhnil,(s) - --
I'I,I,nc I In X: Is atoll Itieclor suns/ ip
-�:xpnns an tan
1'1x11111 6—�Ca 1
_Narnc(prim): C t)11 xtr lira I�(lcror sin 6/ I 1
Mailing address: ' �' (lnit)a le cdis xisa
-ilose IF FF -�
--_-_!'Inlet, 7,11; 1W Icc Irtn cr
I'honc:G o_ Pax: 1 d-t'' f? ntniL ---
nicrceplor grease Trap
Owncr insla111111 tlt/rcvidenllnl ntafntcnancc nnly: The actual (usiallailo,I III Iller(s) —
will Ile m;1de by me or the maintenance and repair mntle by my regular Itlwf l�rnjit(commercial)
etnployec on the plullcrty I own as per OItS t:haplcr 447.
(1,vncr's ;ii;nuhlrc: 11 (x , Ins II(a , ays(s
Date: -Siuigr -
-� I'll I. a towel x xIWCr Ilan '--
Nall I � I nn
�IIIIICss; riilil!1'C 11xC1
t.U)•:i ._... ..� --
- ---- -- - Oil _ -- — -_
'hone: — Irax - rel:
- - I I' 111,111: '1'nlal
Nal all lwlalldlmt 6oerl,l crnar cud,pleue cdl Jwl.h u-. 1„ •w•.I,I d wl Mi11i1t111111 I've................ —
UVis• UMuletCud Notice:'Ihlspcnnilappllcelioll
Cmtil cod numt,u: —/ ! expires If it pent,it Isnal t►Mnined I Inn Icview(ni .� %) 3
wilhln IRO days nnrr it has Bern Slate sun:harge(8710 ....$
-'r�irn'e n cul Iii ri�i ri strewn mriic�l7cii3- —" r accepted as colllph•1,• •1'01 A 1. ............
6 1linunw
4la 4616(M )ATAII
�I��c it;inic;il Permit Applicatimi
Date Iccciveil: 1'w'n►il 11w:
City of Tigard
Address: 13125 SW Ifall Ulvd,'1'i 'ard,()It 1)722.1 1'1°jccUappLllt'• lixpircdltlt:
City of fibtu,r b - -
I'honc: (503) 639.11171 [)file issued: Ily: Receipt m,
ax: (503) 59H.1960 Comic file 1111.' Payment Iylle:
1,7111tl Ilse approval: Ifuitdinl;permilnrl.; - -
U I &2 family dwelling or accessory U conuuereial/indmll ial U Multi-limlil
New conslruclloll U Addition/allclaliu11/rcplaccnlcIII
U OUler: y U'I'enanl in►pnlvenlcnl
)tlll addless: I 1 '-I 5_j w $I �` /�
Ti w R� Intlicale.cllllipillmil Ihlalltllles III poxes IIeIUw. 11,11,Ci11C(IIL'Ilpllill'
11141;,nu•: L1Snile no.: value of all IIIet:I1r,111Cid Ilnllel'In15,cquipnlcnl,lilbor,ovelllcad,
I'»x map/Ulx fol/account no.: prolil. Valle
1.111. lilock Subdivision' x41 1 d1 fPC.IL t
I'rulecl nolle; ._
_l l° c,(,��� Sec t liccklist fur in111011nnl npplicalimi jnli►rmalion and
f .J L l t i juri;di,lion's nix schedule fur lesidcnlhil pelmil lee.
('jly/cuunl'y � l'Y[' ._
WA --
I)cst S1 llil►u and I/Sciltinn t 1 work on premisex: I&KIMMINA&AM Oil2r
V.,1111 '
Iist.dale of couyllclioll/insl►�.clion 5- _ I ccira.) 1'ulnl
rl2 I)rstr{plior' 111 . Iles.only Rtw,olll�
I'ennul inylrovenlcnl or chnngc of usc: r-- -'-11 VAC: -_
Is existing space llcilled Or cnlld111011ed?U Yes U No Air handliulplall ('I'M
Is existing space insulated?U Yes Cl No Alii cr`onditiaII l g`(silt II»n regoiir,li —
_ lernl oil n e`xisln�fiV7CC sysit',�I�- --_--
1 Tlirc?complt ears _
liusincss n,lnlc: T� 1 State bodcl peunil no.:
�IS ��. At Ll�t III' --- ftm; IIIIt/II
Address: ) r_�_._
LL_+:�_�S_--� I'i,t�,mi Ir,lalnl cls taut I ,In ,Lr,l,i,,lu,�
- _ Ilca�pnn,p(�.ilr pl:lll Icrluin'd) -
ln,lallhr ,lacrin,nitee IIr11Cc _
� I'ux: I I�, nmil, 1 ----
- - Inta11dull;duclwolk/vent liner U Yes U No
I'1'll 1111.; 'r, --
-" - - Tnsln lijii,lcchc ocnle tcnlrnx-sllspcnl iT -
1'lly/metro lic. no.: ? -
. _ wall,lit(lrlm mounted
Nnnle(please pr{1::\ /t I l -•tr '�'r'l) _ cn=l w njil,iiniit c of ler I inn ul nit c — -_ -'
1 1 r l l;crsll nn:
Ab•,taplionunils__ _ 11111/II
Nnnlc: rgar�. m��ri! _-q().� 1'lldtels ln'
Addles: -�' �f �" 1, -
5GL Y11._�__C�' -' !S.�?O v tnnpussul s __ -- III'
Cil -- h;l i o41111en N cx I»nsl nrll Ven! nl nu:
City: lime '1.11':
----- Appllan,c will
I�11r I� n,;ul �{hs�'tciiluiiitii-`- —
1 �i�""Is,�l'ype � CCS. IC ILII It17.11n11
Name; t Il�lr'F? r .- t halalliresupplessiunsystem
.�• _ t� jL( F-1 5 C,..., I:xInt11S1l»II WilliRlI1l1iCd11C1(!1011falls)
Mailing nddrrssl F`� � (�� It i 0��`cijllUll �I���(� -jTxjinlist s slcol n►nil CoIT,c»I n,of Ate-—
_- ll�_ t _._1l
1',1y'" l.0 Slnlc: yrj nc p p ng tlnl tIsle ul ou(up to 41111 cls) —
- -•T�ic1-i�'i IT 1 cncii,i1i)t nu» uvt�l�lilill cIs —
L110 NO (Ijl
tnccs�pfiling(50lemaleIc(uilct)
IJ;unr —ll ) / mmil)crfor u1111cis
Addicss r�F -- 111hcrll+Tri)nlipllnoccntegttpmn i : - -
- - I h ,n.,ln'c In,plate
CO Y: I.'iliUc
.-11 'Id: ---• \\''�,�I.In�- /lu act'•lu�r ____ —
�\I�I,hc:nll'•
1 / Vhdc:IL/j/ �llllrl:
ll,nnc (lunill /� 1. (t c-y
Il"d all tu...llln'1lit cmill.plrMr full IINl all/ohlit 1N IINNf IIIIM IIInlllhl 1'c111111 lee.......
Nuittc:'IIli%permit applienliun .........
1 1 Visa 1.1 Muslrlr ,ltd ----
cspites if n pclmil is Iml nbininell Miniuunu fee................
�
".1.1 can)uuudKl ---•---
_ wilhin I Rll days nllcr it lilts heeu
Ilmn'en7rnnilro, t-�f jijuwndil"elctTllGritl e. So ale Sol ulmIIte(RIM,) ...
'I'OTA I. .............. ........f
1'nn{ittddrr N unNne ___
Electrical "I.IlermitApplictation
Dnlercccivcd: -- Permit no.:
r' r ,
Ll� City Of T ig ird Project/nppl.no.: � Iixpircdalc:
l'IIyo/hg a 1.1 Address: 13125 SW IIall Blvd,Tigard,Olt 97221 Date issued: Y Ily: Receipt Ito.:
I'llonc: (503) 039.11171 —
Fax: (503) 598.1960 Case file no.: I'aynlcnl type:
L.allll lose approval:
TYPE OF"PERNI IT
IJ I &.2 family dwelling III accessory U('onnuen:ial/indusrii;11 l_I Multi family U Tenant imptovemeat
KNew conssroclion U Addition/al lerasioll/replaccotenl U Ulhcf: U Pailiul
306-SIlE INFORMATION '
Job nJdress: H20-IT Ittif l_t'._F� -� T' csr0172 l Ifldg.no.: S11ile no,: fax asap/sax slot/account na.:1515GCD 900_
1.01: 11 1 Block: subdivision: 0i5h crt-tK Mir j1owj
Project nti11lc: A i ts-A I 17rscriplion now location of work on premises: NtiAl SI`o,tJ1L Fpq•S-tAu
Listitnated date of completion/inspection; St
`CON]1103'011 APPLICATION
Job no; Fre RUX
Illlsiticss hassle: Q . A . Jerome E l o c 1,r i; Ilescl 1pllon Qly. (cn.) 'total loo.lnsp
AtldreSS: hU QOX 759. Newmildendill-shtgkormilli-fandlyIter
Ihsellingwdl.hlclwleso11nclwdgarage.
City; Hillsboro '11tc01, Zll' 97123 Sa.lr•elncluded:
1'linile: 6411-5144 I"Ox: 6 _ r:-mail: loon sq.t1.or less _ 4
CCII no.: 36051 "t- "'IS- lie.110: Eachnddilionfl
ol 500 aq .or politort Ihcreof -
___3" 11.�_C Limited cncrgy,rcridend_nl 2
Cily/nielrolie._no.: 1063 ^� Limia:dcnergy,nou-Icaidrmitd _ — - 2
knelt nunufacluled Illltlle lir modular dwellilq: - -
Sicaalure of sol KlvisiLil;a eclririnn(rrr a toll) I rn, Selvice nodlot Irrder 2
Stip,elect•rinvile(lit im): fLrt�Lj1 it rmr Im •, I Tet 111 r%ofLo- Ierdrlf-Irlslnllnlluti,
dlrinllollof Irhictilloll.'
PROPERTY 1 1WNE'It 2(111 nmps or Ir%% 2
Name(print): r l_ I wA I -t r Ito C- 2111 ilius IU 4011.nips - — -- -- _ 2
401 nmps 10 600 pulpa 2
M,liliug nr4dlc_ss_`15.7�__S_W_(�u5'1S r���>s �I f�1C�SJ I,nl nlnpttn IIXN)a1(Ips -- 2
City: ' _uYd —! SNlle_��llII':4117 � ovrl I(XX!napsorvciha 2
I'llol :(7 C7 .4 4 I ix:(;,1 CI C11I75li-Ionil: J (teconneclonly 1
Owner installati0n:'[lie inslnllalion is being made on pr•opelly I own Temporally serrlres or feeders-
which is not Intentled (-or stile,lease,rent,of exchange accoldilig to luslrllllllon,dlertdlovi,orrrlocallou:
OILS 447,455,419,670,701. 2110 align or less
2(11 pages Iti 411(1 anryts _1 -
Uwnct's si nnituC: Date: 401 to 600 atom—,i 2_
Drarch circuits-view,alleraflovi,
or exleaslon per panel:
A, I'rr r,.1 1,1 n,t,b 11.1111%wim pmrhnau or
Adds-css: %r•lvir r a1 Irrvlrl Irt•,earl.htalleh ahcoil 1
City: �SInIC: /.I I': II. ser.fol blallrh cnculls willloul 111110101C
----- - ----- - — --- ------ of service or feeder see,fit sl brunets e'Icuil:
r.h )
Thune: I ax: 1? mail - -- ---- — -
hnpddiliooal brulch circuli: _ _
PLAN ItEVkEW t Mlsc.(8erllet or feeder not lurloded):
USelvimcivet I)SunpsInotittcttial UIlrnhh(mc.failllly IlnchLfualpnohllgallollClock — -
U Sri vice over 120 nngts tabic of I A 1 U IIarmdous IIa alion Bach alga of Ilulllae Iiglllhlg _)
h imly dwellillp U Mudding civet 10,1111)(11squmr fert him of S!gaal rFirull(%)tit a lindled energy pnlel,
LISysirrttuvei61X1Vo11%nunthnd naocwollf-nlla)tinllain1nu•%llurocil. n11r1atimi'mI'I.m.i,m' )
l)Iltilldiol;ow1 hu•cslnlu•% I I Irr,Ln,•IiXlnnlpsm loon,. ,Ir,.•, , Iirr,n, .-.._.-._ ..... --' --- - -- - -'-'---- -.----"- ._.
IIIklolr;wlload o. 11)11IN,11% IIIA.,, Ij.Illicit hit wtill.%fit 1(Vpall, Ialhrddilloonlht•,pr,bon ..11ln•n11utu,l.l.r1,t 1.1 llh,•nbn%r•--
ll fgtcsa/hgbliugpino I 11)11.v ____ Put I'r1 nr.l,r,uun
HIIIII1111 %rl%of 1111111% tillpoly of Ilse above. Invttirlgnoonfee -
'I Ile allovr III r vinI applfl able Ito IrulporOil y I�oash 11CIlon eervlce. l►tlu 1 __—-_�_ _ --^ _ -- -
Nd all J.—OwItlint's.eines,,r.1,1141.1t,plrav r all imlullrilat(M Ilton hlftwinalital Notice:11118 permit nllplicnllon Permit 11'c...................
U Vi%a U hlaslelCnd expiles if'n pcimil is licit cibinincd 1'1111 review(til •__ '%,) 5
1.1rdil t41d nu1111wtwilhi11 190 days nllet it has beell State surchnrne(11%) ....
ilei—" 'f OTA II .... . 1'
.__ _ _. accepted us annplclr .........•,..•...
►iMIW til IM,ii 1,lr1 41 drown nn ur,lit,MIT
4-In 46111(641N'1)a1)
ti 46.38
r-
,y
a�ar►o
HbUS E 1O �
F.4=. all.5
r`
,� F.F. Z-1110 �'_ ^ x2AL_L_: ,,,_
W
Q
3
-0 oawtwaY a
W
a° N
0
40.00 �5'JIDmw,&,L_K.
112 +5 .. \/V, f3�- t—h AVE,
LOT 11 ASII CREEX MUADOWS
WASHINGTON COUN'T'Y
MAP 15136CB-900
ZONING R12 LOT SQ. FT. 3617
11245 SW 84Ti I AVT:.
TKYARD, OR
t:SI.INGI.;R P11ILDERS, INC. (503-620-9.515)
I I--75 SW I'M]FICIIWY. I'm 11 160
11.1GA'W, OR 97223
EROSION CONTROL PLAN
1. Silt fence to he instilled pit low side of lot
2. Driveways & sidewalks to he graveled