12065 SW 97TH PLACE 1
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Page No. 1 CASE HISTORY POP *dit NO.: SWR97-0225
ROSE Vih�IOR HOMES
12065 SW 97TH PL PL Unit: PVT
06/18/98
Action Description Req/ Schd/ End/ Actioa Notae Disp By Update Upd
Code Sent Done Dome Date By
SWRA720 Case Finaled / / / / 07/10/:7 PASS TLP 08/21/97 J-H
SWRB003 Application received 06/18/9' / / 05/29/97 RRCD JD 06/18/97 BUN
SWRB008 Permit Created 06/18/97 / / 06/18/97 PASS B 06/18/97 BON
SWRE070 Ready to ieoue / / / / C6;26/97 PASS JDA 06/26/97 JDA
SWRB080 M Issue permit / / / / 06/27/97 PASS DRA 06/27/97 DRA
SWRB705 Sewer Inep^ction 06/18/97 / / 07/10/97 PF.SS TLP 08/21/97 J-H
1�-
1.i
r '
Page No. 5 CASE HISTORY FOR CASE NO.: MST97-0236
ROSE MANOR HOME,
12065 SW 97TH PL PL Unit PVT
06/16/98
Action Description Req/ Schd/ End/ Action Notes Dino By Update Upd
Code Sent Davie Done Date By
MSTB760 Gyp Board Inep / / / / 10/09/97 1. Provide clearance at b-vents. FAIL KS 10/13/97 J+H
2. Screw spacing at ceparal.ion wall not
to exc:,ed 12-inches uC.
3. Orior corrections not done at this
time.
MSTB760 Gyp B,.,3ard Insp / / ! ; 10/13/97 PAS£ KS 10/13/97 J•H
M51'B7'75 Rain Drain Inep / / / / 07/10/97 PASS RAB 07/11/97 J-H
MSTE780 Water Line Insp / / / / 08/26/97 Pressure reducing valve at meter. PASS WA 08/28/97 J+H
M4TB785 Appr/Sdwlk Insp / / / / 04/14/90 PASS MW 04/14/98 J•11
MSTB796 Electrical Final / / / / 12/30/97 ONSS HRP 01/01/98 J•H
MSTB797 Plumb Final / / / / 03/26/98 3/25/98 contractor at COT. "inspector PASS TN 05/73/90 .rr
failed plumbing final because no proof
of newer inspection". THE SEWER IS IN
THE SYSTEM AND HAS BEEN SINCE JULY.
INSPECTOR MUST NOT HAVE T,OOKED. Also,
where is the find plumbing inspection
slip and data?? Contractor in going to
bring in inspection slip to me. Jeanne
T.
MSTB798 Mechanical Final / / / / 01/28/98 1 Need final erosion control approrvyd. FAIL KS 01/29/93 J•H
2. Tape aid spot nails at garage.
3. Support gas piping .t water heater.
4. Post insulation certificate.
5. Support crawl access door.
6. Support heat duct adjacent to crawl.
7. Support heat ducts an needed, also
jy underfloor insulation.
8. Recover vapor barrier an needed.
3. Need to locate low point drain.
10. Remove wood and debris at crawl.
N
MO'fr 1 Aschanical Final / / / / 04/13/98 PASS KS 04/13/96 J•H
f .99 Building Fival / / / / 01/20/98 FAIL KS 01/29/90 J•H
Mf,TB799 Building Final / / / / 04/13/98 1. Support crawl access door. PASS KS 05/07/98 JT
2. Slope finish grade away from
117 structure at side and rear as weather
J
allows.
Page No. 4 CAh'8 HISTORY FOR (ASB NO.: MGT97-0236
a.OSE MANOR HOMES
12065 SN 97TH PL PL Unit: PVT
06/18/98
Action .)escripticn Req/ Schd/ End/ Action Notes Dial By Update Upd
Code Sent Done Done Pate BY
------- ----------- -------- --------
MSTB745 Insulation Insp / / / / 07/18/97 not insulated FAIL RS 08/21/97 J•H
MSTB750 Shear Wall Insp / / / / 09/09/97 1. Exterior Sheathing: Install MSTp97 - FaIL KS 09/14/97 J+H
straps front of structure (upper level).
MSTB750 Shear gall Insp / / / / 09/12/97 Shear wall nailing approved. PASS KS 09/14/97 J•H
MSTB751 Exterior Sheathing Insp / / / / 08/29/97 Nails sunk too deep, do not penetrate FAIL OS 09/01/97 J•H
sheathing surface.
MSTB755 Firewall Insp / / / / 06/12/97 party •gall/separatior. wall not approved FAIL KS 08/1S/97 J*H
MSTB755 Firewall Insp / / / / 08/04/97 k-1- interior side of separaytion wall APP KS 08/04/97 KBS
at upper level
fire tape horizontal joint between
walls
MGTH755 Firewall Insp / / / / 08/3.3/97 #-1- this inspection is for interior A/N KS 08/13/97 KBS
side of separation wall at attic .
MBTB755 Firewall Insp / / / / 07/25/97 Partial separation wall/living area ?ASG KS 08/27/97 J*H
(only)
Call for garage wall when completed
MBTB755 Firewall Insp / / / / 07/28/97 1. Separation wall at garage needs to be FAIL KS 08/27/97 J*H
continuous. Remove section of OPD board
and extend into interior (habit.ble
space).
2. Extend separation wall to out edge at
frcmt of garage.
KOTE755 Pirewa'_l Insp / / / / 07/24j97 not ready to (partywall) PASS KS 08/27/97 J*H
CL.
MGTB760 Gyp Board Insp / / / / 07/29/97 1. Interior side of separation wall at PASS KS 08/27/97 J*H
of garage (lower level).
h
MOTD760 a" 'Board Inap / / / / 10/02/97 Attic drywall nailing, separation walla: FAIL KS 10/03/97 J*H
J
—J Beal around all penetrations if tape is
m
Cri firerated, please provide information.
UJ
J
MNT8760 a" Board Insp / / / / 10/03/^7 Appproved as noted: PASS KS 10/03/97 J•H
1. Seal around penetrations at
separation wall (attic).
2. Mud a tape butt joints and spot
nailing.
Pago No. 3 rASr HI1'TCRY FOR CANE NO.: MST97-0236
RUSE MANOR HOMES
12065 SW 97TH PL PL Unit: PVT
06/18/98
Actior. Description Reg/ Schdi End/ Actic- Notes Disp By Update Upd
code sent Dceae Done Date By
MSTB',30 Framing Insp / / / / 09/15/97 1. Positive connection trimmers to FAIL KS 05/13/98 KBS
header at garage.
2. Provide full bearing under micro lam
at garage.
3. Add brackets at short rafters at
garage.
4. Dcuble studs under micro lam at
stairs,
5. Positive connection glulam to pont
main floor.
6. Nail valley rafters at ledger also
ledger.
7. Provide full bearing under girder
trues at upper level.
8. Nail etude adjacent to tube. Also
fireblock tub.
9. Strap acrosm plates at waste line
adjacent to entry.
MST8730 Framing lnsp / / / 09/18/97 Report dated 091597 KS: Reviewed card FAIL PB 09/19/97 J•H
issues 5, 9, still not complete-l.
q5. Strap glulam at left side of. atairn.
N9. Strip plat at waste, main entry.
NO PLANS ON JOBI
How do you propose to maintain 1-hr.
separation within attic mpace7 Do not
cover until inspected - firestopping
needed at 10-ft. intervals at
horizontal.
MSTH710 Framing Insp / / / / 09/19/97 1-hour firewall prep before 5/8 gyp. FAIL RB 09/24/97 J•H
1. Remove porlins out of firewall
C cavity.
n 2. Firestoppin; required at 10-ft
ti
1/1 intervals, horizontally. Rock wool ok.
> 3. Double blocking at main floor not
E—
.� installed as per plans.
4. Vents within 4-ft of firewall not
m
allowed.
C.7
h.1
J
3.
MSTB730 Framing Insp / % / ! 09/29/97 PASS TLP 09/26/97 J•H
M911374C Gas Line Insp / / / / 09/09/97 1. Gan piping pressure test - 25 psi for PASS KS 09/14/97 J+H
15 mine.
—ydMEEWTM
Page No. 2 CASE HISTORY FOR CASE NO.: MST97-0236
ROSE MANOP. HOMES
12.065 SW 97TH PL PL Unit: PVT
06/18/98
Action Descripvion Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent ioue Done Date By
------- -------- -------- -------- ---`---- -- --------------------------------------- ---- -- -------- ---
MSTB705
----------
MSTB705 Footin3 Inep / / / / 07/01/97 1. Approved per plan/ separation wall PASS KS 07/02/9'7 J•H
detail.
2. Excavate doth of FTS as shown.
MSTB705 Footi,lg Inep / / / / 06/30/97 USA insp not posted FA_L RC 07/08/97 J•9
MSTB706 Foundation Insp / / / / 07/07/97 1. Provide :uichor bolts PASS RB 07/07/97 J•H
2. Re-bar cu':, straps req'd
3. Anchor bolts at 1-hr firewall
(spacing 6 clear mce)
4. Bearing pads
S. Venting (needs 0 vents).
6. SB" oc anchor blt intermediate walls
SEE REPORT (THIS IS BRIEFED).
N.STB709 Wtr Proofinj Bom't Walls / / / / / / 05/1.8/97 BON
MSTB710 Post/Beam Structural / / / / 07/17/97 APP KS 05/13/98 KBS
MSTB711 Poet/Beam Mechanical / / / / 07/17/9'7 PASS KS 08/02/97 J•H
MSTB712 Plm/Underfloor / / / / 07/11/97 NOTED: Are you using approved flux? Pipe PASS MS 07/11/97 J-H
would not turn green with approved flux.
MSTB713 Crawl Drain / / / / 05/13/98 approved by conversation t..is date with APP KS 05/13!9" JT
Ken S.
MSTB717 underfloor insulation / / / / 07/21/97 1. Covor (wrap) plumbing line. PASS RB 08/27/57 J•H
2. Back-water valves required at low
point..
3. Lip vapor barrier.
4. Protect plumbing service from fr"ezm.
MSTB'723 Electrical Service / / / / 09/09/97 not, ready NR MJP 09/09/97 MJR
MSTB723 Electrical Service / / / 09/15/97 PASS MJR 09/16/97 MJR
r MSTB724 Electrical Rough-in / ! / / 09/08/97 PASS MJR 09/08/97 MJR
F.
MSTB725 Mechanical Inep % / / / 09/09/97 Apprcved as i.oted: Connect. exhaust. fame. PASS R9 09/14/97 J•H
J MST13727 Lor' Voltage / / / 12!30/97
PASS BRP 01/01/98 J•H
MSTH729 Plumbing Top Out / / / / 01/29/98 FASB M9 01/28/98 PDP
G] �
C' 1
W
J
Page No. 1 CASE HISTORY FOR CASE NO.: MST97-0236
ROSE MANOR HOMES
12065 SW 97TH PL PL Unit: PVT
06/18/58
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code rent Done Done Date By
MSTA050 Hold for / / / % 04/19/98 Sent final inspection back to Ken S. HOLD JT 05/07/98 JT
Holding C/O until confirmation frim Ken
that it's okay to proceed. Missing
inspection(s); crawl drain/poet&beam
structural, final plumbing approved?
Joanne r
5/7/98 received slip back before Ken
went on vacation. No followup.
I sent file to Hap to for review.
MSTA720 Mechanical Insp / / / / 09/10/97 PASS KS 09/15/97 J-H
MSTA726 Shear Wall Insp / / / 08/19/97 #-1- STHD # 14 ho.ldown not instal'.ed at DIS Kn 08/19!97 KPS
garage side wall
0-2- provide 'toldown connection
,'.eta'-1#/26 beam to
upper level
# 3- MST # 72 otrapn not installed at
'cont ofstructure
MSTA740 Insulation Innp / / / / 09/30/91 Insulation installed in wall@, crawl PASS PDC 10/01/9'1 J•H
space and ceiling in garage. Attic
iueulation not installed, verify attic
insulation at final inspection.
MSTA960 (F) Inoue Cert, of occupancy / / / 04/L3/98 MAII:ID 6/11/98 MAIL VN 06/11/98 VLN
msTAoo5 App.ication re-eived / / % / 05/29/97 PECD JD 06/18/97 BON
MSTBOOS ^etmit created / / / / Of•/18/97 .,ASS B 06/19/97 BON
MSTBolo Check for prel. restrict. / / / / 06/18/97 PASS B 06/18/97 BON
MSTB012 Plano routed to Plana Examiner / / / / 06/18/97 PASS B 06/18/97 NON
MSTB026 Bldg/mach pians apprd by CPS / / / / 06/19/97 APOP RDP 06/19/97 RDP
f is
)-- M9T1303O Reviewed plane routed to DST@ / / / / 06/19/97 RDF' 06/19/9'7 RDP
N
_ MSTB032 DST Plan Review Completed / / / / 06/20/97 PISS 8 06/23/97 BON
)-- MST13050 Hold for / / / / 06/23/97 On hold pendiig SUB conditionn of HOLD B 0,,/23/97 BON
J approval.
c�
MST13090 (F) "early to issue / / / / 06/26/97 All fees paid. American Mechrni,,al needs PASS JDA 06/26/91 JDA
11.'
� all contractor information for plumbing
sub contractor
MSTS092 (F) Issue combination per .L / / / / 06/27/97 PASS DRA 06/27/97 DRA
M-TH095 Issue plumbing signature f,a'm / / / / 07/16/97 RECD SM 07/16/97 S•W
MSTB097 lonue Electric Signature Fore / / / / 07/24/97 RECD SM 07/24/97 S'N
MSTB700 Erosion Control / / / / / / 06/18/97 BON
CITY GF TIGARD
DEVELOPMENT SERVICES
20 ik 13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171
C.ERTIFImu. OG-'
Orr:IJPANC:'r'
PERM I T #. . . . . . . : MST9 7-0.:36
VATS ISSUED: 04/1 :;/9t3
PARCEL i 2S 10EBA-04300
ITE ODDRESS. . . : 12065 SW 97TH PL FSI._ #PVT
UBDI VISION. . . . : LUBL IN MARE; ZONING 2 R--rr_':s PD
i01_OCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 2013 JURI'3Dlr:l'IONiTIG
CLASS OF WORK. :NFW
TYPE OF USE: . . iISFA
TYPE OF CON TR:5N
OCCUPANCY IPP. i R3
OCCUPANCY I..OADi;
Remarks i FCA •- Path t
,,0SMANOR HOMES
GSI NW CONSTRUCTION
10620 SW LUCAS DP
11JALATIN OR 9706.:
Phone #i 452•_613:2
Contra►r.tor4
FOSE MANOR DOMES INC
Sw L CAS DR
TUALAT I N OR 970E+4
Phone #i 45' -8133
i�pg 1#. . : 109866
Phis Certificate grants oc'c-'upancy o1' the .kbovp r pf"Prenc:ed bui ldi.iig or portion
thereof and confirms that the bui.iriing has been inspected for romplian..:e wife-,
the State of Ocegon Specialty Cucips fu;4 t'ie gro-up, ocruppn--,.,, and uee under
which the . refevenred permit wa!r tismed.
DJIL 1.NC; INGkoF_C.T17RAI../INSPECT'I 5UE'ERV ; �IIf
J
ra PO31 IN CONSPIC:UUUE, PLACE
J
I
5F-lU
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: 13' �1J �A.M. P.M. _ MST: 7—�7
location: /,Z O �S , 7ff BUR _
Tenant. Suite: B:dE- _ NEC:
5� O(�
Cnntractor:���,.. ����� Phone: �. PLM:
Owner: _ Phone:
_ —_ ELC:
_—_ EI,R:
SIT: _
BUILDING LDG(coni PLUMBING - rCHANICAL ELECTRICAL SITE
Site Pos earn P.--,t/BeamPow Cover/Servicc Sewer/Stonn
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-in UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault*
Bsmt Damp Drywall Storm Flame 'Temp Service NIISC.
Masonry Ceiling Rain Drain A/C lJG Slab
Shcar/Shea0l___._f:i -S lkIr/Alin Crawl/Found Dr Iieat Pump IA7w VC
�(1p_fL_o Approved + Approved A )roved Approves! Approved r
Appr/Sdwlk Not pprov:d Not Approved Not A rove Not Approved Not Approved
FINAL FINAL INAL FINAL FINAL
_ee
rY
J
LL!
Call for reins n Reinspection tic of S_ required before next inspection C1 1 Inable to impect
Inspector Date Page I a e or
F-,
l crry Q TIGARD MASTER PERMIT
DEVELOPMENT SERVICES PERNIT #. . . . . . . : MST97-0236
DATE ISSUED: 06/27/37
13125 S Hall Blvd., Tigard,OR 97223 (503)639.4171
PARCEL: 23102BA-04300
SITE ADDRESS. . . : 12065 St4 137TH PL PL. #PV•T
SUBDIIJISION. . . . :DUBLIN PARK -09 ZONING: R-25 VID
BLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . . :013 JURISDICTION:
Remarks: SFA - Path i
----—------------------------------------------------------ BUILDING -------------------------____-------------------- ---- ----
REISSUE: STORIES.......: c FLOOR AREAS--------- - BASEMENT...: 0 sf REQUIRED SE1`PACKS---- REQUiRED-------------
CLA55 OF WORK.:NEW HEIGHT........: 22 FIRST....: 742 sf GARAGE.....: 240 sf LEFT.. .......: 5 SMOKE DETECTRS: Y
TYPE OF USE...'A4 FLOOR LOAD....: 50 SECOND...: 537 sf FPONT.........: 2P PARK1Nr SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT ........: 0
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 2 TOTAL-------: 1279 sf VALUE..S: 89808 REAR..........: 20
--------------------------•-------------------------- -------- PLUMBING -------------------------------------------------------•-----------
SINKS.........: 1 WATER CLOSETS.: 2 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 100 TRAPS.........: 0
LAVATOP'ES....: 3 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 3 CATCH BASINS..: 0
TUB/SHOWERS...: 1 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PRE'JNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
-------------------- ------------------------------ MECHANICAL --------------• •—--------------------------------------
FUEL TYPES- --------- FURN ( 100K .. ; 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 2 CLOTHES DRYERS: 1
GAS FURN )=IW, ..: 1 UNIT HEATER5..: 0 HOODS.........: 0 iTHER UNITS...: 0
MAX INP.: 1750x10 BTU FLOOR FURNACES: 0 VENTS.........: 0 WDODSTOVES....: 0 GAS OUTLETS...: 1
----------------- - - - --------- --- --------------------- ELECTRICAL -------------------------------------------------------------------
--RESIDENTIqL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRAIJCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 1 0 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500Sr.: 1 201 - 400 amp.. : 0 201 - 400 amp 0 15t W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: b
MANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 --------------------------------- PLAN RCVIEW SECTION --- -----------------------------..
Reconnect 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 6 STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM.: OT H: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: X CLOCK..........: INSTRUMENTPTION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: 0
Owner: -- - ---- ----- -- - -----Contractor: -- -... ---- - TOTAL FEES:$ 3848.3@
ROSE MANOR FUMES ROSE MANOR HOMES INC This permit is subject to the regulations contained in the
GSI NW CONSTRUCTION 1060 SW LUCAS DR Tigard Municipal Code, State of Ore. Specialty Codes and all
10620 5W LUCAS DR TUALATI4 OR 97062 other applicable laws. All work will be done in accordance
TUALATIN OR 9 062 with approved plans. This permit will expire if work is
~- Phone #: 452-8133 Phone #: 452-8133 not started within 180 days of issuance, or if the work is
N Reg L.: 105868 suspended far more than 180 days. ATTENTION: Oregon law
----------------------------------------------—__-_-----------. requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth :n OAR 952-001-001@ through OAR 952-001--0080. You may obtain copies of these rules or
-' direct questions to OUNC by calling (503)246-1987.
--------------------------------------------------------- REQUIRED INSPECTIONS ----------------------•---------•-------------------------
�' Erosion Control Post/Beam St-•uct Plm/urdslb Insp Plumbing Top Out Shear Wall Insp Water Service In
-' Grading Inspecti Post/Beam Mechan Electrical Servi Framing insp Firewall Insp Appr/Sdwlk Insp
Footing Insp Ple!Underfloor Electrical Rough Gas Line Insp Gyp Board Insp Sprinkler Underf
Foundation Insp Crawl Drain Mechanical Insp Gas Fireplace Rain Drain Insp IOrinkler Rough-
Wtr ProofingSlab Insp ow Voltage In,ulation Insp Water I iq Insp Additional......
Permittee Si: natl.rre:
+++^+++i + w -I +./ ....-I..}-�-+••i-..4+4 tit F+ f++.1 } i•} }++ F
Call 635--4175 by 6:00 p. m. for an inspection needed the next br-rsi.ness day
CITE" OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW Hall Blvd., Tigard,OR 97223 (503)6,79-4171 PERMIT
PERMIT #. . . . . . . : 5WR97--0225
nATE ISSUED: 06/27/97 +
PARCEL: 2S 1 O,�BA-04300
'SITE ADDRE:SS. . . : 12065 SW 97TH PL PL_ #PVT
SUBDTI'ISION. . . . :DUBLIN PARK ZONING: R-25 PD
BLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . . :0l3 JURTSDTCTION:
TENANT NAME. . . . . :ROSE MANOR HOMES
OSA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NE14 DWELLING 'JN I TS. . 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL TYPE. . . . :BIJSWR TMI=SERV :3URFACE: 0 sf
Re mat-k s : SFA - Fath 1
Owner: __-_..___________________._____.-_-_....__..__._.. .._.__.__.._._.__.____._---- -----___-.- FEES -- -- - ---- --_
ROSE MANOR HOMES type amol-tilt by date r-ocpt
GSI NW CONSTRUCTION PRMT $ 20'00. 00 DRA 06/-7/97 97--E'9G516
1OF,; O SW LUCAS DR It`It�P 35. 00 DRA 06/27/97 97-296516
TUAL_fl'fIN OR 97062
Phone #:
Gontractut': - - ------------•------------------
OWNER
Phone #: $ 2235. 00 TOTAL._
Reg #. . :
--- --- REG1U T RED INSPECTIONS
---- ---
This Applicant agrees to comply with all the rules and regulations Sewer Inspact i.on
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The t-.tal amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement _
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral. __ —
r TENTION: Oregon law requires you to follow rules adopted by the
Orogn� Utility Notifiration Center. Those rules are set forth in OAR
195?--301-0010 through OAR 952-00P:-0080. You may obtain copies of _
these rules or direct questions t� OX by calling (503)246-1987. _r
e r m i t t e e S i g n a t r_r r e :
+++4+++++4+++-F++4++•+++++++++++++4 +++++++•h+++-&-+i.+++++++++++++++i.+++++++-F+++++++++
Call 639-41.75 by 6:00 p. m. for an inspection needed the next br_rsiness day
++++4.++++++++++++++++++++++++++++++++++4-+++++++++++iii•+++++++++++++++++++4-++++++
e
CheUc ian P
7( OF TIGARD Residential Building hermit ApplicationPlan
By 0
25 SW HALL BLVD. New Construction Additions or .Alterations Date Recd
;ARD, OR 97223 Single Family Detached or Attached (,Duplex) Date to P E
503-6394171 Oate to OST (o l '
503-684-7297 Permit s(`1 i ` �-QZ�hju�Q'd`
Prim or Type Called
Incomplete or illegible applications will not be accepted
Name of Project Name
Job
Address Site adress Architect MailiniAddress
C /S ate Zip Phone
�i
i?�s�i� h rr�llc "5.I-)VN r)'. O c L. Y I'Ple ;?5
Owner Mailing Address N
06i o<, SGt/ kii C" at J14t c'7t
CqqrState Zip I Phone Engineer Mailing Address
li1li 0yr e 'y z Y L"i 3 3 f!S 3,7- /c -
r Name C. State z o Phone
General �rJ51U&t} 'X' cn}c's T-,L'c Describe work New Addition O Alteration O Repair O
Contractor Mailing Address to be done.
J 1 6(( 4.2 Additional Descnpaoi,of`Nork:
C, State Zip Phone
c,a n drk f .y,- - /3
repo Const. Cont. Board Lic 0 Exo Date
Attach Copy of LJ ',.
Current COT Business Tax or Metro 0 Exp. Date PROJECT
Licenses _Name . VALUATION $ O
�
Mechanical f� NEW CONSTRUCTION ONLY:
Sub- ailing Address Sq. Ft. House: 73~ Sq. Ft. Cara e
r o
Contractor at - Z :G,.,., !� Corner Lot YES NO Flag Lot NO
C. r5tat r
l,Zip y Ph ^y y, t (check one (check one)
Cregon :onst Cont. Boara Lic A Exp Date Restricted I ` I Audic/Stereo Burglar
tach copy of I I _ Energy ✓ System Alarm
CurrentCOT Business Fax or Metro A Lro.Owe Installation Garage. door � HVAC
_icenses
- Name y Opener Systems
(check all that Other.
Plumbing 1 , t /fijG„r! v,c,sL apply)
Sub- Mailing Address Will the electrical subcontractor wire for all YES NO
'Ontractcr CV f.SLQCc < restncted energy installations?
C. (state Phone Has the Suodivision Plat recorded NIA YES NO
0 Egon Con t. Cont. Board Lit KI Exn. Date Reissue of MS7:* Solar Ccmpliance
a. attach copy of i (Calculation Attached)
Current Plumbing L7e. M I Exp.Date I I hearty acEnowledge that I have read this application, that the
N L,ce�ses i COT Business Tax or Metro to ExD
information given is correct. that I am the owner or authorized
I . Date I agent of the owrer, and that plans submitted are in ccmpiiance
vara with Oregon State lgv
it-^ Sign 9f 0 rt lent �– Date
EleL,:
2 L Q
..
Sub- Mewing Acaregg�✓ 4 Contact Person Name—'—Y' Phone!t
Contractor 3 > i�t� Wl �7iy� �l>a� S �. s L/s-� - 132 .
CState Z;o Phone FOR OFFICE USE ONLY:
1s` 77 PlatI: AM �"L#
Cr cn onst. Cont. Board Lic.tl xC Det! ^ - ?�' 1 7 A (1
Attach copy of
.(,'7( 1 11-2,1-R Setbauts: Zone: J Solar:
Current E'ewtcat Lic.0 Exp.Dote r l
Licenses 3 �7
c'ngineenng Aporovalla ning Approval: TIF
COT Business ax or Matro is i Ex D tq _
11 L
'sfapp.00c(dst) 1/97
Perms A n Description Amount Amt. Pd. r�
MST Permit (BUILD) L)o ✓
Plumb. Permit (PLUMB)
klech. Permit (MECH) '.�� _ �o—✓
ELC/ELR Permit ,ELPRMT)
State Tax (TAX) 27
_7
Bldg: L. '6
Plumb. 9
Mech.
ELC/ELR:
Plan Check
MST. (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN) 7 -9
CDC Review (LANDUS)
-__ C b`Bly zv
Sewer Connection (SWUSA) ?,
Sewer Inspection (SWINSP) 3S
Parks Dev Charge (PKSDC) ldno - �(,� ✓
Residential TIF (TIF-R) -7O
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) fb
it
un Erasion Control Permit (ERPR71T)
Erosion Planck/USA (ERPL*N)
m
.4
)
Erosion Planck/COT (EROSN) 1:
Fire Life Safety (FLS)
TOTALS: '? 15, 3 a
�.� 3
'sfapp dac �dst) ti97
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97 Jun 1B 09:48:32 R:1LnLT1314DP SATURN IM.R.R.1
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ROSE MANOR HOMES, LTD.
UPI (PH.) 452-8133
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CITY OT TIGARD
DUBLIN PARK
\\ �• LOT 13 12065 S.W. 97TH PLACE
LOT 14 - 12047 S.W. 97TH PLACE
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N 26'06'4 E s f6� N 26'06'e E ALAN MASCDRO OFSION ASSOCIATES.INC 3
IS NOT LIABLE FOR THE ACCURACY OF THE C Z
`
II — ,._, TOPOGRAPHY NFORMATION It 18 THE SOLF
- -1 RESPONSIBILITY OF THE BLRGER TO VERIFY ina
All SITE CONDITIONS.INCLUDING ANY FILL J O
S.W. 97TH PLACE (PRIVATE ROAD)
PLACED ON THE SITE PFLO WORM GONERSrl
OF ANY AOr;rrul c�ElO MOOK�CAnONS Q