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Qt Of O Oa) c O to LL Chco CUC O LL (') G E N a n n N E :9V ,mq rn o o to LL u r' c7 rj —5n m 2 U N C14ON a rD rn00 rn00 Onn, n m cOp m a m m m m m m Q G~/1 !n to N N to rn N N OF OC CITY OF TIGARD C ERMTA#:EMS 97003ANCY, DEVELOPMENT SERVICES DATE ISSUED: 06/27/1997 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 r'ARCF.L: 2S102BA-04400 ZONING: R-25 JURISDICTION: TIG SITE ADDRESS: 12047 SW 97TH PL PVT FILE COPY SUBDIVISION: DUBLIN PARK BLOCK: LOT:014 CLASS OF WORK: NEW TYPE OF USE: SFA TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TENANT NAME: PEMARKS: SFA- Path i Final Building Inspe tion and Certificate of Occupancy Approved 3/31/98 by Ken Schnendl, Building Inspector Owner: ROSE MANOR HOMES GSI NW CONSTRUCTION 10620 SW LUCAS DR TUALATIN, OR 97062 Phone: 452-8133 Contractor: ROSE MANOR HOMES INC 10620 SW LUCAS DR TUALATIN, OR 97062 Phone: 452-8133 Reg #: This Certificate grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under whip: the referenced permit was issued. BUILDING INSPECTO L761LDIN OFFICIAL POST IN CONSPICUi:IS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUF `I -L/t ate P,equestcd_ AM PM _ BLD l Location �,�.0 � Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC _ Retaining Wall GLR Footing Foundation Access: i � /L� 9L i FPS Fig Drain SGN Crawl Drain inspection Notes, 1 -- Slab SIT Post&Beam --- Ext Sheath/Shear ' IInt Sheath/Shear Framing Insulation — Drywall Nailing Firewall —�— Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof Misc: __ —_- Final �- PASS PART FAIL PLUMA-BI NG Post& Beam -- ---- - Under Slab Top Out -- ---------- - -- �— Water Service Sanitary ger --- - -- Rain Drair Final ------------ �—_ — PASS PART FAIL ` MECHANICAL Post& Beam ---- — Pr ---.--- --— Rough In r Gas Line - ------ ------------ --- - ------- — Smoke Dampers Final - -- ----------- — -- PASS PART FAIL ELECTRICAL -- --- - - - -------- Service Rough In UG/Slab > Low Voltage ~ Fire Alarm -� Finai PASS PART FAIL SITE Backfill/Grading ��-��- -----�-— — Sanitary Sewer Storm Drain ( ) Reinspoction fee of$— required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ) Please call for reinspe,lion RE — _ [ ] Unable to inspect-no access Fire Supp' Line ADA Approach/sidewalk Other Date Inspector—_ _ _Ext Final LPASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : MST97-0237 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 06/27/97 PARCEL: 2SI02DA-04400 SITE ADDRESS. . . : J.':-'047 SW 97TH Pl_ #P1)T SURD I V 15 I ON. . . . :DUBL I N DARN, ZONING: R-25 PID BL.00I:. . . . . . . . . . I-OT. . . . . . . . . . . . . ..014 JURISDICTION: Remarks: SFA - Path 1 -------------- -- ----------------------------------------- BU I LD I Nt- ------------------ REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEW141...: 0 sf REQUIRED SETBACKS---- REQUIRED----------•-- CLASS OF WORK.-.NEW HEIGHT........: 22 FIRST..... 742 sf GARAbE.....: 240 sf LEFT,.,.....,... 5 SMOKE_ DETECTRS: Y TYPE OF USE... :SFA FLOOR ;OAD.. ..: 50 SECOND...: 537 sf FRONT.........: 20 PARKING SPACES: 2 TYPE OF CONST.:SN DWELLIN" UNITS: I FINBSMENT: 0 sf RIGHT.........: 0 OCCLM CY GRP.:R3 BORM: 3 BATH: 2 TOTAL------: 1279 sf VALUE..f: 99908 REAR..........: 20 --------------------- ---------------------------------- PLUMBING ---------------_..------- ------------------—------------- SINKS.........: I WAIER CLOSETS.: 2 WASHING MACH..: I LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 100 TRWc:. .......: 0 LAVATORIES....: 3 DISHWASHERS...: i FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB/SHOWERS...: 1 GORBAGE D15P..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 ---------------------- -- MECHANICAL ----------------------------------------------•--------------- FUEL TYPFS------------ FURN ( 1009 ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 2 CLOTHES DRYERS: 1 GAS FURN )=100K ..: I UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS. .: 0 MAX INP.: 175000 BTU FLOOR FURNACES: 0 VENTS.........: 0 14MDSTOVES...... 8 GAS OUTLETS...: 1 --------------------------- --------------------------------- ELECTRICAL -------- ----------------------------------------------------- --RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MiSCELLHNEOUS---- --ADD'L INSPECTIONS-- ION SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 asp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 1 201 - 400 asp..: 0 201 - 400 asp.. : 0 1s1 W/D SVC/FDA: 0 SIGN/OUT LIN IT: 0 PER HOUR......: 0 L1MITFD ENERGY.: 0 401 - 600 asp .: 0 401 - 600 amp..: v EA ADDL 8R CIR: b SIGNAL/PANEL...: 0 IN PLANT......: 0 MANE HM/SVC/FDR: 0 681 - Ib00 asp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0 1000+ asp/volt.: 0 ------------------------------------- PLA? REVIEW SECTION ---------------------------------- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMIre- CLS AREA/SPC OCC- ------ ---- ---- ------------------------------------ ELECTRICAL - RESTRICTED ENERGY -------------------------------------------------- A. -------- - -- A. SF RESIDENTIAL---------------------------- B. COMMERCIAL-----------------------------—_-----------------------___._. .--------- -- AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM...... INTERCOM/PAGING: OUTDOO!, L.NDSC LT: BURF+LAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAi'E/IRR1G: PROTECTIVE SIGNL: GAR*E OPENER..: X CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: HVAI............: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: 0 Owner: -------------------------------------Contractor: ------ ------------------------ TOTAL FEES:$ 3848.36 ROSE MANOR HODS ROSE MANOR HOMES INC This permit is subject to the regulations contained in the GSI I4W CONSTRUCTION 10620 SW LUCAS DR Tigard Municipal Code, State of Ore. Specialty Codes and all 10620 SW LUCAS DR TUALATIN OR 97062 other applicable laws. All work will be done in accordance TUALATIN OR 97062 with approved plan,. This permit will expire if work is ,. Phone N: 452-8133 Phone f: 452-8133 not started within 180 days of issuance, or if the work is Reg 1..: 109868 suspended for more than 180 days. ATTENTION: Oregon law --_--__-------------- requires you to follow rule~ adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 thr•ougir OAR 952-001-01 0. You may obtain copies of these rules or ~ direct questions to OX by calling 15031246-1987. J REQUIRED INSPECTIONS Erosion Control. Post/Ileac 5trnct Plm/undslh Insp Plumbing Top Piet Shear Wall Insp Nater Service In grading Inspecti Post/Beat Mechan Electrical Servi Framing Insp Firewall Insp Appr/Sdwlk Insp Footing Insp PIP/Underfloor Electrical Rough Gas Line Insp Gyp Board Insp Sprinkler Underf Foundation Insp ---- Crawl Drain Mechanical Insp Gas Fireplace Rain Dra' Insp Sprinkler Rough- Wtr• Proofing m ab Insp Low Voltage Insulation Insp Water in Insp itional...... n Iss,_red 13 I\ Permittee Signatr.rre: ++++++++ ++++++++++++++++++++++++++•t++-4-+r-++1 +++++++++f++++++++ h+ +++++++++ Call. 6313-4175 by 6:00 p. m. fo►^ an inspection needed the next business day CITY OF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION 1='ERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171 PERMIT #. . . . . . . : SW R 97—0'' E: DATE ISSUED: 06/27/97 SITE ADDRESS. . . : 12:1047 SW 97TH PI- #t P V..l.. PARCEL: `S 10E'BA--0A 400 SUBDIVISION. . . . :DUALIN PARK, ZONING: R-25 PD BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :014 .iURISDTCTION: TENANT NAME. . . . . : ROSE MANOR HOMES USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0 .LASS OF WOI*RV. . . :NF!J DWELL I NG UPJ I TS. . : I TYPE OF USE. . . . . iSrA NO. OF BUILDINGS: 0 INSTALL- TYPE. . . . :BUSWR IMPERV SURFACE: 0 Sf Remar-ks : SFR — Fath 1 Owner: —___..____—.----------_-----_.____._._______.._—_------.--._._.___.______ Fr-LS ROSE MANOR HOMES type amol.tnt by date recpt GSI NW CONSTRUCTION PRMT $ c202. 00 DRA 06/27/97 97-296519 10620 SW LUCAS DR MSF' $ "3. 00 DRA 06/27/97 97--29651'' TUALATIN OR 97062 !-'hon,- #- 0 T) :orr t;Tact or: __ ---•-------- -------------- i]WI�IE R Phone #: $ 4.235. 0'X1 TOTAL Rey i#. . ------- REQUIRED INSPECTIONS -------- This Applicant agrees to comply with all the rules aid regulations Sewer Inspec-tion 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 l,cated at the oeasur•ement given, the installer shall prospect 3 feet in all directions from _ the distance given. If not to located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agenry will install a lateral. ATTENTION: Oregon law requires you to fallow rules ad;vted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0001-0080. YOU may obtain copies of these rules or di t_questions to OK by calling (503)246-1987. v: \ J T -;Sl.ted b ri L-w Permittee Signatr.c e :_ LL; -J +++•-+++i•+t++4......-F...4-F++}++.+++t+i-,-+++-14...t++-F+-F++t+....F.....tt+++.....+-F+++ Call 639--4175 by 6:00 p. m. for an inspection needed the next bi.tsine';5 day +++++++++•F+f•++++++++++++4•++++++++++++++++++++++++++++++++++++++++++++++++++++++ i Plan Check is Y OF TIGARD Residential Building Permit Application Recd By �- 25 SW HALF_ BLVD. New Constrt;ction Additions or Alterations Date Recd as? •ARD. OR 97223 Single Fam:y Detak-hed or Attached (Duplex) Date to P E.b-IS iO3-639-3171 Date is DST 03-684-7297 Permits 1 1`17-0 3? `>t)C-7- Print or Type Called Incomplete or illegible applications will not be accepted Name of Project Mame Job c' ° ,it. �'1 Site ddruss Arch�teet Mailln Ac:dress —Address _ z I. -- /art fc, Nie Cdyi tate Zip Phone Owner Mailing Address Nartt� Engineer C'tyrState Zip Phone Mailing Address y2W 40g -;- 5r ame C/tyiState Z o Phone General - a.'b c-s T-'V Descnbe work New Addition O Alteration O Repair O Contractor ailin�q Address to be dine c Adddtcnal Descnptior,of Work: C- /state Zip y-/,°t.' Phone L C i Oregon Const Cont. Board L c X Exp. Date Attach Copy of OZ111U , ' //. C �r "I, — Current COT Business Tax or Metro 1$ Fxp. Date PROJECT L;censes VALUATION L$� Na a --f c NEW CONSTRUCTION ONLY: Mechanical �'�- / Sub- Mailing Address — Sq. Ft..tiouse. Sq. Ft. Garage Contractor C,pystat ' ' Corner Lot YES Ng Flag Lot YES NO zip Pnone check one t_ C.L '7C 3b �1�I 5 St' ( ) _ (check one) _ Cregon Const. Cont. Board L c i/ Exp. (late Restricted Audio/Stereo Eurglar Attach copy of 3��1� 1 Energy ✓ System Alarm Current COT ausiness Tax or Metro a Exp. Date — Installation Garage Door ✓ HVAC Licenses Noma Opener Systems (check all that Other Plumbing E�[' C-/�2r� / �-c./ c apply) Sub- Hailing Aoaress Will the electrical Subcontractor wire for all YES NO Contractor ` /gyp 6v©C E y restricted energy installations7 i Ctstate Z;p �r�hone Has the Subdivision Plat recorded? N/A -I YES NO 441 ruy un Yk,53- Cregon Can t. Cont. Board Lic.# i Exo Date Reissue of NIST# Solar Ccmplia-ice i Attach Copy of rL Current Plumbmg L c a (Calculation Attached) � Exp. Date I hearby acknowledge that I have read this application, that the l to Licenses COT 9usiress lax or Metro Exp Date information given is correct. that t am the owner or authorized � ►— I arent of the ow•-sr. and that plans submitted are in compliance Narne , xith Oregon Ste.e laws. Sfqp.Vyre of OwnQiAgent Date ' ElectricalLD Sub- Marling Act Tic )� s- ,� Contact °erson Name Phone# Contractor Sia C.^ ate Z:o Phone FOR =FICE USE ONLY. Z� 73 Plat ft: Mapffl-* Or an Const. Cont. Board Lac is cx Otte 2(p z Z-J '4100 1 ttach Copy of D1t 76 7V1 /_g Sit lacks- I Zon�j_ _ Solar. Current E'4�/cat L.c ! Exp ae I �( ` 2- _,tenses r 3�1 ) S ry rJ -/ - EngmeAnng Appr vol: I tannin Approval: TIF C T Busrnes T x or Metro a p Date-� 3� ._ 1 _ G' it �+u 4 �f P �i: p�.doc;dst) 497 per P-rmf # Ac oun n t; Ap2glLnj Amt. Pd foal Die NIST Permit (BUILD) Plumb. Permit (PLUMB) r�s� Mech. Permit (MECH) so ELC/ELR Permit (ELPRMT) State Tax (TAX) r ++ Bldg: Plumb: Nlech: s'a ✓ ELC/ELR: Plan Check MST: � j� 4sJ ✓ f. (BUPPLN) Plumb: (PLMPLN) Mech; (MECPLN) CDC Review (LANDUS) 4a cy-rw i I Sewer Connection (SWUSA) Zlr� Sewer nspection (SWINSP) Parks Dev Charge (PKSDC) ���'� /(�U ✓ Residential TIF (TIF-R) 1970 Mass Transit TIF (TIF-MT) Water Quality (WQUAL) F_ Water Quantity (WQUANT) Erosion Control Permit (ERPRMT) _ ! n 4.1 . Erosion Planck/U,13., (ERPL#N) /1 r J Erosion Planck/C17 (EROSN) Fire Life Safety (FLS) TOTALS: 7,srapp.doc rasp 797 97 Jun 18 09:48:32 R:%LnLT1314DP SATURN IM.R.R.) Ig \\ 4 ®06 1 I BY : ROSE MANOR HO''OS, LTD. \N (PH.) 452-8133 1 IN \�� CITY OT TIGARD 1 I\ °s\.` DUBLIN PARK LOT 13 - 12065 S.W. 97TH PLACE I \ \,t LOT 14 - 12047 S.W. 97TH PLACE 1 I \ NO TE.• GRAVEL DRIVEWAY TRANCE PER EROSION CONTROL I I \ LIJ 1 1 - I \ I � I I ^ \ I 1 \ \ I I \ I I a En all \ ►— I I I \\ Lu I UJI ; LOT 13 I LOT 14 `� \ r (6,000 S0. FT.) ( 4,736 S0. fT.) N \ CV 1 I p' \ � � c\I a. Ln ry. I I N I��1 \ f�.\L J'•. Q LLUL 1 z \ v 0 O I I ( \ O o 6's I \ r' MAIN FLOOR -MAIN-FLOOR- ` ` CT) U ' EL :166.5' -t- -166 ' \\ ~ O ) a t7 3 In I i z9 \ s.. 0 �c o 18'.2" , GARAGE GARAGE - ./ � Q J i FLJ -�---t- 1 .:166 0 // LLJ a COVC 4'CONC DRIVEWAY ( DRIVEWAY 06/17/97 MRRC W 13900 PSI 1 13600 P e n o � N 28.0 _ v 18.5 t, y f i �\ win �� * i b 08.89 42.82' n Nil. N 26.08'4 " E r - N 28.08'4 - E / °� ALAN MASCORD DESIGN ASSOCIATES.INC 3 -- \ a NOT LIABLE FOR INF ACCURACY fK tNE � Z TOPOGRAPHY NFORMATION IT I$ THE SOLE ��-„,,._-,_ _ ___. - ,>-.-_ —. _. ---_. ..-✓i INSPONS14UtY OF THE BUILDER TO Al”, Q --- ALL!'1E CONDITIONS INCLUDING ANY FIL -� N Wc!T H PLACE (PRIVATE ROAD) OF ANY m1 TIIE SITE AND NFORN OWNERS „ OP ANY POtFNTIAI T.FLO MOOIt irATlpy$ � f`7