12053 SW 95TH AVENUE A
i
14I DRr.SS:
J
cc
k.
co
LL1
i:\records\rnicroflrn\targelsV)ui!dirig.doc
Page No. 1 CAS: HISTORY FOR CASE NO.: MST97-01.99
ROSEMANOR HOMES
121153 SW 95TH AVE
06/08/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
code Fent Done Done Date By
MSTAC05 Application received / / / / 05/29/97 RECD JSD 06/16/97 DRA
MSTA008 Permit Created / / / / 06/10/97 PAS,. DRA 06/16/97 DRA
MSTA010 Check for prcl. restrict. / / / / 06/16/97 Fireplace site 24" into side yard PASS URA 06/16/97 DRA
setback, per Bob T is okay via planning.
MSTA012 Plans routed to Plans Examiner / , / / n6/10/97 PASS DRA 06/16/97 DILA
MSTA030 Reviewed plans routed to DSTS / / / / 06/11/47 APPR RAP 06/11/97 PDP
MSTA050 Hold for / / / / 04/03/38 hold c/o, received slip that's not HOIA JT 06/03/98 JT
entered, and ken finaled bld, but crawl
dr, has failed, inspection slip back to
ken, holding c/o until confitmation from
him that it's okay to procesn c/o.
F/3/98 got a call from Judy Schwartz
(new homeowner), gave her info about
final, she is leaving a message for Mike
S., does sump pump take the place of
crawl drain? Jeanie T. Homeowner also
noted she is having drainage problems
MSTA092 (F) Issue combination permit / / / / 07/16/97 PASS DRA 07/16/97 DRA
MSTA095 ?nous plumbing signature f,7rm /
/ / / 09/10/9, PECD SW 09/11/97 S•W
RECD 9W
MSTA091 Issue electric signature form / / / / 08/15/97 0S•W
MSTA70L Erosion Contol / / / / / 066/15/97/11/97 RDP
MSTA705 Footing Innp / / / / n7/17/97 1. Needs initial erosion control FAIL KS 08/02/97 J•H
approval.
2. Provide compaction report to Bldg.
Dept. from soils engineer.
3. Post address and permit no.
MSTA706 Founaaticm Inap / / / / 07/24/97 PASS K9 08/26/97 J•H
MSFA710 Post/Seam Structural / / / / 07/30/97 2nd inspection thin date PASS KS 0t/J1/97 J•H
ft
PL9TA710 Post/Beam Structural 08/01/97 / / 07/30/97 REMOVE INSULATION, CALL BACK FOF. FAIL K9 08/01/97 J•H
G/1
PEIN9PECTIUN, DO NOT DECK UN-11, 70pT 6
BEAM STPUCTURAL/MECHANICAL HAVE BEEN
APPROVED.
rr
CQ
M
07/30 97 2nd ins ecticm this date PASS Ks 09/01/97 .I•
MSTA7L1 Fnet/beam Mechanical / / / / / P
MSTA711 Post/Beam Mechanical 09/01/97 / / 07/30/97 Under floor insulated prior to FAIL K9 n8/01/97 J•H
inspection - remove inwilation for
inspection.
MSIA713 Crawl Drain / / / 03/OC/98 Unable to 10c-Ate. pee F,i lding final FAIL 09 n3/09/99 J•H
this date.
MSTA717 PLM/Underfloor / / / / 07/30/97 PASS MS Ob/20/97 J•H
10
Page No. 2 CASE HISTORY FOR CASE NO.: MST97-0199
ROSS'MANOR HOMES
12053 SW 95TH AVE
06/08/98
Action Description Req,/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA720 Mechanical Inep / / / / 09/11/57 1. Needs elect. cover 6 plumbing top out FAIL KS 09/17/97 J-H
approval prior to framing inapstion.
2. Secure collar at fireplace and
maintai-, cle.rance to combustibles.
3. Vent exhaust fan at utility room.
4. Remove insulation shield at b-vent to
verify clearance.
5. Can piping p.t. - 25 psi
MSTh720 Mechanical Insp / / 1 / 09/17/17 Approved an noted: PASS KS 09/17/97 J•H
1. Remove saw dust adjacent to b-vent
prior to replacement (of insulation
shield).
MSTA722 Plumb Top Out / / / / 09/09/97 PASS MS 09/14/97 J-H
MSTA722 Plumb Top Out / / / / 09/08/97 No test on DWV above lot floor. FAIL RAA 09/14/97 J•H
MSTA722 P_ :.rb Top Out / / / / 09/15/97 Already approved by MS on 9-9-97. PASS FAB 09/15/97 RAB
MSTA723 Electrical Service / / / / 09/15/97 Low voltage not ready, serives 6 roughin PASS MJR 09/19/97 J*H
approved.
MSTA724 Electrical Rough In / / / / 09/15/97 PASS MJR 09/19/97 J•H
MSTA725 Framing Insp / / / / 09/15/97 UNABLE TO INSPECT, MECH ROUGH IN FAILED FAIL KS 09/17/97 J-H
THIS DATE.
MSTA726 Shear Nall Insp / / / / 08/22/97 Shear inspection wing walla at garage PASS KS 08/25/97 J-H
only.
META-726 Shear Wall Insp / / / / 09/19/97 #-1- courtesy inspection meet with N/R KS 08/19/97 KBS
framer
MSTA726 Shear Wall Insp / / / / 09/10/9.7 1. No plans on site (Jeff) . FAIL KS 09/14/97 0-H
F--
N
> MSTA727 Low Voltage / / / / 09/15/97 not ready FAIL MJR 09/19/97 J+H
J
M8TA729 Low Volta," / / / / 12130/97 Some patching needed around recept. PASS BRP 01/01/98 J•H
cc
r.
LL1 MSTA715 Gas Lite Innr / / / / 09/15/97 25 rsi PASS KS C9/17/97 J•H
J
MSTA740 Insulation Inor / / / / 07/31/97 PASS K8 08/21/97 J•H
MITA745 Gyp Board Inep / / / / 10/1.1/97 Approved an notedc Seal void behind PASS KS 10/13/97 J'H
furnace with gypsum or 26-gauge sheet
metal. Will check at final inspection.
MSTA755 Rain drain Insp / / / / 07/29/97 PASS RAB 00217,'91 .7-11
Pa..je No. 3 CASE HISTORY FOR CL3E NO.: MST97-0199
ROSEMANOR HOMES
1205:1 SW 95TH YIE
ob/08/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA760 Water Line Inap / / / / 08/:.6/97 Pressure reducing valve at meter. PASS 'dA 08/29/97 J-H
MSTA765 Appr/Sdwlk Inop / / / / 03/06/98 PASS MW 03/06/98 J•H
MSTA790 Electrical Final / / / / 12/30/97 some patching needed around rucept. PASS BHP 01/01/98 J•H
MSTA797 Plumb Final / / / / OI/28/98 PASS MS 01/29/99 MRS
MSTA799 Building Final / / / / 03/12/98 1. Need electrical final for sump pump FAIL KS 03/12/98 J•H
circuit.
3. Repair foundation screen at sump pump
line.
3. Slope finish grade away from
structure at sides and rear as weather
allows.
MSTA960 (F) Inoue Cart. of Occupancy / / / / 03/12/98 06/08/98 JT
14STB705 Footing Insp / / / / 07/18/97 1. Needs initial erosion c-mtrol FAIL KS 08/27/97 J•H
approved.
2. Post street number/addrean and permit
number.
3. Locatj corners of property linea (set
string for reference.
MOTB705 Footing Insp / / / / 07/21/97 1. USA Erosion control approval PASS ..a 00/27/97 J*H
required.
2. Provide adequate keyway.
3. Provide 7^ depth of footing.
including thru stepping.
4. Maintain bearing pai •requirements.
S. Maintain seismic regairements as per
alc"rnate brace panels.
6. Remove vegetation `.rom footing.
MSTE711 Poet/Beam Mechanical / / / / 07/31/97 PASS KS 09/21/97 J•H
MSTB713 Crawl Drain/Backwater valve 01/09/99 / / 03!06/98 App- v a at inspection report dated PASS NA 03/09/98 J*H
t/1 01'8 99 by Ms.
H
M.9TB717 Underfloor insulation / / / ! 07/31/97 PASS FS 09/21/97 J*H
CO
�1
..l
Page No. 4 CASE HISTORY FOR CASE. NO.: MST97-0199
ROSE4ANOR HOMES
• 12053 SW 95TH AVE
06/08/98
Action Dencripti.m Reg/ Schd/ End/ Action Notes Disp By update ttpd
C,lde Sent Lone Done Late By
MSTB730 Framing Inap / / / 7 09/23/97 1. Provide TJI detail. 2. Strap across PASS KS 09/25/97 J•H
splice at top plate above garage header.
3. Strap trimmers to header at garage.
4. Strap each nide of wall to 8.75 x
18-in. glulam beam at garage, 8. Provide
3-inches of bearing under 4 x 12-in.
beam front of structure. 6. TJI top
flanged damaged need approval fr.=
manufacturer. 7. PRovide full bearing
glulam beam at living zoom. 8. Positive
connection beaos to etude main floor.
9. Truss clip missed rear bedroom. 10.
Extend eave baffles 18-inches above
bottom of truss chord at blown
insulation. 11. Fireblock tab/shower.
12. Sway brace truss an shown. 13.
Mechanical soffit not built aL garage.
MSTH730 Framing Insp / / / / 09/26/97 Correcti,-na c,mpleted. PASS TLP 09/26/97 J•H
MSTB745 Insulation Innp / / / / 09/29/97 PASS KS 09/29/97 J•H
MSTB7E0 Gyp Board Inap / / / / 10/03/97 1. Seal void above furnace at ceiling FAIL KS 10/03/97 J•H
with gypsum or 26 gauge sheet metal.
2. Storage area under stairs needs to be
covered with gypsum.
j. Replace qypsum ar. garage, butt joint
at framing member.
MSTB760 Gyp Board Inas / / / / 10/07/97 1. Seal void above furnace, will check PART r•, 10/08/97 J•H
at final.
M.9TB795 Misc. Inspection / / / / 03/12/98 Sump pump wiring okay - job has been PASS PRF 03/13/98 J•H
a
� finaled, anter this an a special
rx
F--
inspection for record purposes.
N
MST3799 Mechanical Final / / / / 01/28/98 PAIL RS 01/29/98 J•H
MSTB'198 Mechanical Final 03/09/95 / / 03/06/98 PASS GS 03/04/98 J•H
p] MSTB798 Mechanical Final / / / / 03/12/98 PASS KS 04/27/98 J•H
r.
CD
111
J
Page No. 5 CASE HISTORY FOR CASE NO.: MST97-0199
ROSEMANOR HOMES
• 12053 SW 95TH AVE
06/08/98
Action Description Reg/ Schd/ End/ Action Notes Diep By update Upd
Code Sent Done Dane Date By
MSTB799 Building Final / / / / 01/29/98 1. Need final erosion control. approved. FAIL KS O11'2y/98 J-H
2. Patch holes at garage.
Strap water heater.
4. Provide landing at patio door.
5, Smoke detector not functional at
mant_er bedroom.
6 Extenu guard rail 36-inches above
finish floor.
7. Provide hand rails at otairs.
S. Insulate crawl access door and any
voidn
9. Remove wood debris at crawl.
'.o. Need to locate low point drain.
Ii. Slope finish grade away from
structure.
MSTB799 Building Final 03/09/98 / / 03/06/98 Per final report dated 012898 by KS: PAIL 68 01/09/98 J•H
1. Still unable to lucate underfloor
drain (expose and call or reinspection).
2. Complete grading between 12053-12077
SW 9th Avenue.
MSTB799 Building Final / / / / 07/12/98 Approved as noted: PASS KS 04/27/98 J•H
1. Need electrical final for sump pump.
2. Pepair foundation screen at num pump
line.
7. Slopr finish grade away from
structure at sides and T@a] an weather
allows.
03/11/98 Cancelled by request of builder at site. CANC. KS 03/11/98 J*H
n.
CIOF—
J
L7
IL;
J
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
CER`FIFICATE OF
OCCUPONCY
PERMIT #. . . . . . . s MST97-019
DATE 1GSUED: 03/12/98
PARCUL: 29102DA--03:200
;ITE ADDRESS. . . s 12053 SW 95TP A c
'JBDIVISION. . . . x DUBLIN PARK ZON.INOsR- ::5 PD
oL.00K. . . . . . . . . . i LOT. . . . . . . . . . . . . 100:2 JUR I SD I CT I ON:TI Cr
CLASS OF WORK. s1\1FW
'T'YK'E OF UrE.. . . :SF
TYPE OF CONSTR,3N
OCCUPANCY GRP. :R3
OCCUPANCY LOAD-2
Remarks s Pith 1
Owner;
RO SE MANOR HOMES
10£20 SW LUCAS COURT
TUAL I T I N OR 97062
Phone #: 452--813:3
C'ontracturd
FUSE MANOR HOMES INC
10620 SW LUCnS DR
TUALVITIN OR 57062
Phone M. 452--813:3
Rew #. . : 109868
This Certificate uramt a uccl.-ipancy of the above referenced Gui ldiny or portion
thereof and confirms that the building has been Inspected for compliance with
the �itate of Oregon SpeciaIty Codes for the gromp, ncc:upa►rrcy, a►nr+ use undei.
which the referL�nced permii; was iasued.
UILDING INGPEC FOR _.,. AI_/INSPE I, 1�1�Sq� ts 717
J
POST IN CCOW3PI,CUOUS PLACE:
cz
J
I 7c-u ��'
CITY OF TIGARD BUILDING INSPECTION DIVISIONp;'
W' 24-Hour Inspection Line: 6394175 Business Phone: 639-4171 PUIV710
Date Requested: .� ' 0 _ __—
C A.M. � P.M. MST: 'J
Location:_ Z C�c� _ � -- BDP:— —
Tenant: _ — Suite: _Bldg: NEC:__--
Contractor:_—� ��}�}(,L(.�'LQ,Q-'{'`.� _.Phone: = � �L_ PLM: __-
0%vner: Phone: _--- ELC: _
ELR:
SIT: _
BUILDING BLD PLUMBINGECHANICAL:. ELEC-TRICAL SITE
Site Post/Beam Post/Bearu Pos n Cover,'Scrvice Sewer/Storm
Footing Roof Undl]/Slab Rough 4n Ceiling Water Line
Slab Framing Top Out Gas Linc Rough-In UG Sprinkler
Foundation Insulation Sewer IloodfDuct Reconnwt Vault
11smt Damp Drywall ..,irm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/l-ound Dr Heat Pump Low Vol" _
Approved Approved Approved
Appr/Sdwlk C=Pof A i rr,,ed Not Approved Not Approved Not Approved
FINAL_) F!NAL FINAL FINAL FINAL
I
�/ (�Y 'TC�/���Z _G=Eu.�ci�_4?70N �C-l��'.3t/�.1 � `..�vs..vr'l,�c�w � ,lo.✓✓' --
I ^'Y �iS i,"�r �i!r S� t��/�� f•�A Z__�"�s�t �j:12''J G•!-C/L� v/��=s�
i
1
r�-
r
ca
0 Call for reinspecai Cl Reimq.ection fee of S required before next inspection 7 1 hrable to inspect
of
InRpector: _ --._ - -- Date: —�
CITY OF TIGARD MASTER F,ERMIT
DEVELOPMENT SERVICES PERMIT t. . . . . . . : MST'37--0'i 33
13125 S W Hall Blvd., Tigard,OR 97223 (503)639-4171 D A•r r--. I S S LJ E U: 07/16/97
ST TE. ADDRESS. . . : 12053 SW 95TI-i AVE
SUBDIVISION. . . . :DUDLIN PORK ZOIUING. R -25 F,D
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :00 JURISDICTION: TI1"i
Remarks: Path 1
-------------------------------------------------------------- BUILDING --------------- ---
REISSUE: STORIES.......: ? FLOOR AREAS---------- BASEMENT_- 0 sf RFOUI'?EC SETBACKS---- RE007� ED-------------
CLASS OF WORK.-NEW HEIGHT........: FIRST....: 864 sf GARAGE.....: 484 sf LEFT..........: 5 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOP, LOAD....: 50 SECOND...: 690 sf FRONT.........: 20 PARK 146 SP4CES:
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 5
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL------: 1554 sf VP1_UE..1: 112520 REAR..........: 24
--------------------------------------------------------------- PLUMBING ----•-----------
SINkS.........: 0 Ill1TE CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 100 TPI."S.........: 0
LAVATORIES....: 3 DISI ASHERS.,.: 1 FLOOR DkAINIE..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 0 CATCH BISINS..: 0
TUB/SHOWERS...: 2 GARBAGE DISP..: 1 WATER HEATERS.: I WATER LINE ft: 100 8CKFLW PREVNTR: P GREASE TRAPS.: 0
OTHCR FIXTURES: 0
--------------------------------------------------------------- MECHANICAL ------------------------------------------------------------ __.
FUE1. TYPES----------- FURN ( 100K I ROIL/CW ( 3HP: 0 TIENT 1 43.....: 3 CLOTHES DRYERS: I
GAS FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: d
MAX INP.: 150000 BTU FLOOR FURNA"ES: 0 VENTS.........: 1 WOODSTOVES....: 1 GAS JUTLETS...: 1
_------------------------------------------------------------- ELECTRICAL -----•----------------------
---RESIDENTIAL UNIT--- ----SERVICE/FEEDER-•--- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS—— --ADU'L INSPECTIONS--
1000 SF OR LESS: 1 0 - 200 alp..: 0 0 - 200 alp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 3 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 2 1
LIMITED ENERGY.: 0 401 - 600 alp,.: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNFL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: C 601 - 1Q10 amp.: 0 601+asps-1000 v: 0 MINOR LABEL --10: 0
1y,0:04 alp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION --- -- ---------------- ---- ..
Reconnec+. only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -------------
A. SF RESIDENTIAL---------------------------- B. COMMERCIAL-----------------------------------------------------------------
AUDIO 8 STEREO.: VACUUM SYSTEM..: AUDIO A STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
9URGLAR ALARM..: 0TH: :: BOILER.........: HVAC...........: LANDSCAPF/IRRIG: PROTECTIVE £IGNL:
5ARAGE OPENER..: X CLOCK..........: INSTRUMENTATION: MEDICAL.L.......: OiHR:
1VAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL q S\'STEMS: P
Jwner: -- ---- --------------------------Contractor: ----------- --- TOTAL FEES:1 44'18.80
PGSEM�_fflR HOMES M MANOR HOMES INC This permit is subject to the regulations contained in the
10620 SW LUCAS COURT 105;'0 SW LUCFS DR Tigare Municipal Code, State of Ore. Specialty Ccdes and all
IUALITIN OR 97062 TUALATIN OR 97062 othe- applicable laws. All work will be ;lone in accordance
with approved plans. This permit will expire if work is
^hone t: 452-8133 Phone N: 452-8133 not started within 180 days of issuance, or if the work is
Reg A..: 189868 suspended for or-: than 180 days. ATTENTION: Oregon law
-----------_---------- -------------------------------------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in CAR 97-001-001e through OAR 952-081-0080. Ycu may obtain copies of these rules or
c
direct questions to OUNC by calling (503)246-1981.
•
----------------------------------------------------------- REDUTRED INSPECTIONS -----------------------------------•---______---------
r, Erosion Contol Crawl Drain Electrical Rough Gas Line Insp Water Service In building Final
Footing Insp PLM/Underflcor Fra,:ing Insp Insulation Insp Appr/Sdwlk Insp _
Foundation Insp Mechanical Insp Shear Wall Insp Gyp Board Insp Electrical Final _ -------
Post/Beal Struct Plumb Top Out Low Voltage Rain drain Insp Mecha.lical Final
Post/Bean hon AA Electrics a vi Fireplace Insp Water Line Insp Plut b ' l _
Isar-red 13y: 1, Per^mittee Signatl_rre : _w
4- +-+-1 + i +} #4 + + +fi { I4411 }+? + ii � +++11ii ++ +•+4+++++i4 +14 .+.1 1.+i +♦ 1 +i I i } 441 + i4 I
Call 639 -4175 by 6:00 p. m. for an inspection needed the next bl-rsines5 day
CITE' OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW Hall Blvd., Vgard,OR 97223 x.503)639.4171 PERMIT
PERMIT #. . . . ., . . . SWR97-O22*2
DATE ISSUED: 07/16/97
PARCEL:
SITE ADDRESS. . . : 1`053 SW 95TH AUE
SUBDIVISION. . . . :DUBLIN PARE: ZONING: R—LE:'S PD
DLOCI... . . . . . . . . . LOT. . . . . . . . . . . . . :002 JURISDICTION- T I G
TENANT NAME. . . . . :DLJDI...I N PARK LOT 2
USA NO. . . . . . . . . . : FIXTURE UNITS. . . 0
CLASS OF WORT;. . . :N'W DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1r
INSTALL.. TYPE. . . . :LTP I MPE TSV SURFACE: 0 s f
Remarks : Single family residence
Owner,: ___._______________..__.__ ______...__._---_..._ ._...__._____._.__--.--__.-_....__.-._-- FEES
ROSEMANOR HOMES type amoi-rnt by date r-ecpt
10620 SW LUCAS COURT PRMT $ 22,00. 00 TAT 07/16,197 97—x'97230
TUALITTN OR 9706 : INSP $ 35. 00 TAT O7/16/9.7 97 _97'=3,0
Phone #.
Contractor,: ----------.________________-______—
OWNER
F h o r,e #- $ 2035. 00 TOTAL
Reg #. . .
REOU I RR D INSPECTIONS
-
I;iis Appli.ant agrees to comply with all the rules and regulations Sewer Insper_t i.on
of the Unified Sew.ge Agency. The permit expires 190 days from
the date issued. The total amount prid 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 meeiurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires you to follow reies adopted by the
Oregon Utility Notification Center. Those rules are set forth i• JAR
E- 952401-0010 throlsgh OAR 952-0001-0090. You may obtiin copies of
these rules direct 4Ue5t1Gn5 to UUNC by calling (503)246-1997. W__
T 5 s _red _ F'ermittce Signature :_-
c^
++4.......1 ++-1-++4+++++++-+++-F+++++++++++++++++-r-F•+++++•F++++++++++++-F++++++++..
Call 639-4175 by 6:00 p. m. for an inspection needed the next bl_rsine:.s day
h+- t-++++++++++4-4......4..............1-++++4-4......4-+4-+4...4-++++4..................4 i
Plan Check 0
`Y OF TIGARD Residential Building Permit Application Recc,By
.125 SW HALL BLVD. New Construction Additions or Alteration-, Date Recd 7
IGARG, OR 97223 Single Family Detached or attached (Duplex) Dare to P _UL-IC, <"I mak-
! 503-639-4171 Care to DST (o
= 503-684-7297 Permit ry 1 q
r---
Print or Type Called
Incomplete or illegible applications will not be accepters
Name of Project dame
Job A/,/,/), AIA'/C 2WA11O7 /) .-<),`A)r-,
Address Site Andress — Architect Malting Address
„s i'
Name/ , Jk- Y City/State zip Phone
/,> ar i( Sr /r A+�/K f�,:tr J li!c LA)k1li,L t� R 0x
Owner Mailing Address Name
c�
�, '``� �'��` l"`'� �7 y.Par
Cily)State Zip Phone Engineer sneer Marking Addres!
Nai ne .ty/State Zia Phone
eneral Descnba work New Addition O Alterat on O Repair O
ontractor Mailing Andress to be done:
__SL,, 4,ee,4 5 Additional Description of Work:
crtyrstate zip Phone
if ` 7^lv "�- J%.3�
Oregon Const. Cont. Board Lica Exp.Date _
:h Copy of //'!8/ S, // ')- ; ;,
:urrent coT Business Tax or Metro rt Exp. Date— PROJECT
_icen.:�os VALUATION
Name
,,iechanicai NEW CONSTRUCTION ONLY-,
/F`- 7 meq. Ft. House: Sq. Ft. Garage
Sub- � M cling Address
,ontractor
6-1 IIWAJ K AD 7rner Lot YES NO Flaa Lot YES NO
City/state, Lip ivy Phone (c, eck one) �. (check one
Crecon Con .Cont. Board L c 7 Exp. Date Restricted Audio/Stereo Burglar
rvcn copy or ef�`_���� / Energy System Alarm
:urrentC..t Business Tax or Metro K 1Exp Date Installation Garage Door NVAC
tenses i Opener ) Systems
Name ' (check all that Other
umt:ing _&,ye /J A) �')/I TCr44A) CQtq _ aPoly) _.
Sub- ;ding„duress Will the electrical subcontractor wire for all YES NO
�ntractor /"Q(} lye F 0 restricted energy installations '
'ate z p akin e J Has the Sutuivlslon Plat recorded N/A YES NO
Cf"or,t,anst Cont. Board Lc 0 I Exp. Date I Reissue of MS-f4 Solar Ccmpliance
a .h copy or
n :ur-rent P!umbmg L:c.# Exp.Date _ (Calculation Attached)
t--
v r,ensea I ( I Nearby acknowledge that I 'lave read this application, that the
ir•)rmation given is correct, 'hat I am the owner or authonzed
COT Business Tax or Metro 0I Exp. Date i agent rf;he awr.er, and that -+fans submitted are in compliance
Name Jvith Oregon State laws. _
�iggature of Owner/Alart Date
ectrical ( 7-er,C.5 i
Cl�
Sub- Mailing Acdress
i ontact Person Name Phone#
)ntractor j /.?C� �� / p,tCrlr`J �� Sfln��fiz s �/
:State ' zi Phnne FOR OFFICE USE ONLY:
C-4-f- ' 2 C / O - 5 -`7 r'i � z --- Map/TLJt
Oregon Const. ant Board Lic M Exo D e
:h.Copy of "etbacks: i Zone. v Solar:
.,rrent E e cal Li f Exp. Date �_
senses '-11`G , /6) / yEngineering?approval I Planning Approval: TIF
COTc9� ate
mass Tax or Metro rr Exp. D
___ 7 6,;) 31— iAsfapp.doc(dst) 1/97
Permit # AccQ LrjLQ_ec&ription LA Amt. Pd. �I 6U
MST. Permit (BUILD) U�
Plumb. Permit (PLUMB) -,
Mech. Permit (MECH)
T
ELC/ELR Permit (ELPRMT)StateTax (TAX)
Bldg: —
Plumb: _ rj qo ✓�
Mech:
ELC/ELR:
Plan Check
NIST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN) ✓ `�>' �,S
CDC Review s (LANDUS) ,�-'2� 2
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) �f
Parks Dev Charge (PKSDC) ic�•�i) �/' Io;
Residential TIF (TIF-R) 1 C, ,j t �s `7o
Mass Tra^s!t TIF (TIF-MT) i Z
Water Quolity (WQUAL)
Water Quantity (WQUANT) /UI> /01)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) 20�°
Erosion PlancVCOT (EROSN)
Fire Life Safety (FLS)
TOTALS: _ f� C/L,' ! ( ��C�?• ��
1.11!20�.doc (dst) 1/97
t`
17%14v 'S 17 49.04 N.LT',L%0P SATURN W R,R.1
r _ 1677
\ / ` BY
ROSE MANOR. HOMES, LTD
2 (PHI 452-8133
CITY OF TIGARD
f
DUBLINPLOT
2
I✓ 12053 S W. 95TH AV[:
J,6J! S0. f7.)
NO rE.
GRAVEL DRIVENA Y EN FRANCE
\69 ?° /� ` PER EROSION CONrRpI
Q Q
QvU)/A /// WW L•♦ //
rA,
/�C /
/ / V
�6►• ` < / MAIfJFLOOR
\ o /
EL s166 /
0 ,
2r./• �� GARAGES
4' CONIC -.a 165
DRIVEWAY
49, 13500 17500 PSI I h G
`a o 0.
h Cl/ A '
' h
C].
rt
to
H
J
rr
[S]
C7
LQ
J
0)5128197 MRP.
ALAN YASCOND DESIGN ASSOCAtES.HC
S VDT LIABLE FOR " ACCJPACT'.1F IMF.
'OPCGPAPWESporsal K(MYIf& IT *0 SOLE
ALL SITE Copr OF "�gnomo •0 vERWY
-ILt
All SITf CONpTgNS NCL UDND ANY cAL \
PLACED ON IK SITE AND KOPY OWN[Ni; )
OF ANY POTENTIAL FELD YDOFiCAt*"
ALAf1 11A1t0QD DFfi0n AI l0A T C f
1305
'4W 19T14 AVENUE, PORT!AND. OREGON 97209 (503) 225-9161 S C A L F 2 0 0 "