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Pay at City Hall, 13125 SW Hall Blvd Catch Basin �\ { [ Please call for reinspe^tion RE: - [ )Unable to inspect-no access Fire Supply Line ADAo ch/Si ew Ik ate - � Inspector Ext L 1 Othe Final ASS PART FAIL DO NOT REMOVE this inspection record from the job site. Cp��� ®� �����D CERTIFICATE OF OCCUPANCY PERMIT#: MST99-00125 DEVELOPMENT SERVICES DATE !SSUED: 05/11/1999 13125 SW Hall 31vd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110BA-08300 ZONING: R-4.5 FIL E JURISDICTION: TIG SITE ADDRESS: 14130 SW 116TH TERR Cop y SUBDIVISION: EVERGREE=N SPRINGS BLOCK: LOT:008 CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TENANT NAME: REMARKS: New SF - Path 1 Final Building Inspection and Certificate of Occupancy Approved 1/6/00 by Rick Bolen, Building Inspector Owner: RENAISSANCE CUSTOM HOMES 1672 SW WILLAMETTE FALLS DR WEST LINN, OR 97068 Phone: 557-8000 Contractor: RENAISSANCE CUSTOM HOMES 1672 WILLAMETTE FALLS DR WEST LINN, OR 97%8 Pho le: 557-8000 Reg #: �n T ti J ti This Certificate grants occupancy of the above referenced building or portion thereof and confirms t,.=+ the building W,s been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use un�Wr which the referenced permit was issued. ( ` BUILDING INSPECTOR BUILDING OFtICIAL POST IN CONSPICUOUS PLACE CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00303 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE 13SUED: 09/24/1999 SITE ADDRESS: 14130 SW 116TH TERR PARCEL: 2.S1109A-08300 SUBDIVISION: EVERGREEN SPRINGS ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURESLAUNDRY TRAY6 SF RAIN DRAINS: SINKS: _ URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Residential backflow prevention device. -- — -- -- - Owner: - FEES — Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT KJP 09/24/1995 $25.00 99-318596 1672 SW WILLAMETTE FALLS DR WEST LINN, OR 97068 5PCT KJP 09/24/1995 $1.75 99-0318596 Total $26.75 Phone 1: 557-8000 Contractor: MOODY ENTERPRISE INC PO BOX 98 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 631-2918 RP/Backflow Preventer e� Reg #: Llt; 00005973 Final Inspection PLM 11717 INAL This permit is issued subject to the regulations 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. :L 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 tollow 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 to OUNC by calling (503) 246-1987. Issued By:/� . Permittee Signature: aC�L Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next business day �/foci TY OF TIGARD Plumbing Application Ral fly Cil :125 SW-HALL BLVD. Commercial and Residential Dat.Rec'a 'i TL ` y GARD, OR 97223 Oats to P.E. A3) 639-4171 T Date to DST ! r� Permits Print or Type / Relived SWR s Incomplete or illegible applications will not be accepted called Name of Devewpmert/Proiect FRES.Aildlyldual) .Qi+ ;r Job Sink "'� ai l �_ �/►MT frtt" 0.00 Addr. is Strael Ad cess Suite Lavatory 0.00 t . U 1� 114 /6 r'� G' Tub or TutuShower Comb. 9.00 Bldg a G f tate Ziok �. 22� Showe75ny - water Closet 0.00 N� O UO /�P�vrl i f V c �� �oit Ill ta- oi'hwasher 9.00 Owner �"rg Suite C'�a7s Dliiposat 0.00 6 _� e c a waahwg M.aw,e /State Zip q Phone 0.00 >' �✓O /70 vv =Oroin 0.00"7dUC) El 000 0.00 Occupant MAru^0 Address Swle water Meatal 9.00 GtylState LP Phone Vundry Room Troy T"0 Urkal 0.00 Name / Otter Fbrt lino(Sp") 0.00 C[U �r✓�['i1. , P •, rt' I -- 9.00 Contractor fiAading Add ss Suite P-LO, /S - 9.00 (Prior to issuance City tate / Phone 9.00 applicant must -S �i0I�A Off' 0z3 6 -211/15 _ 9.�0 contractors Oregon Conr;L Cont.Board Ljrc* �r Date O.W G D OU license Plumbuhg informaLiG s Ex to 0.00 fbn P Sewer-1st 100 for COT COT Busuiess Tax M or etro• saw" each additional 100 25.00 (fattbase). 20 49 gate Water Strvip_1st 100' -- 30.00 Name water Sn ice-each additional 200' 25.00 Architect Storm 6 Ran Dram-1st too' or Marang Address Suite Storm&Ran Drain-each additional 100•Hor 25 00 Engineer ty GrState �Spam25.01: �P PhoneCorvnerctal Back Flan Prsvemlon Dewce or Mil Pofkrt on Devils 25.00 'es�tbe work New-�AddiHor,O Alteration U Repair O Resxfer,tfal Backflow Prnvantfm Device• tit+done: Resrdentlal Gid Non-residential O 15.00 dd;Uonal desrnptun of work My Trap or waste cwt Corxhected to a F'ucture 9.00 Catch Basin 9.00 c� 1 nj Insp,of E�nsbng Plumbing A/tf x)II 1 et QaG J �d 40.00 t r w permr C1. usung use of Specially Requested Inspections X0.00 - Acting or property_____ c` Ramperft Drain.single tvnity dweiiing 30.00 ✓� -:c-osud use of Grease Traps -- } iding or property9.0 QUANTITY TOTAL -e you capping, molmN or replac,ng any fixtures? resp No 0 F70PL�ANREV�IEV-4*2 r"ser diagram is rWK"r6d a Quanly ToW a >9 ryes see back of form) _ �� 'SUBTOTAL j ^reby aduwwcedge that I have read this application,that the information _ w �n is correct t.'iat I am the owner or authorized agent of the owner.and - 5'r6 SURCHARGE "i Mars urbmitted are m comoliance with Oregon State Laws. a of OvWmF- A Ant /D oats 5'!. OF SUBTOTAL Aeavnd_an I fbmn pry total is>g ` intact Person Name TOTAL r fee Phone . .• / t / 7/V 'Minimum permit is S25 55%surdrarge,except Residential Backflow I ! /�/��(/' G J 7 Prevention Device,which is$15•5%surcharge .�.., I:\pima .dchc 12'96 dst �� �� ������ MASTER PERMIT PERMIT ax: MST99-00125 DEVELOPMENT SERVICES DATE ISSUED: 5/11/99 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 14130 SW 116TH TERR PARCEL: 2S11013A-08300 SUBDIVISION: EVERGREEN SPRINGS '1 ► ,,� ZONING: R-4.5 BLOCK: LOT: 008 01 y If JJ� /� RISDICTION: TIG REMARKS: New SF - Path 1 I�u BUILDING a REISSUE: STORIES: 2 FLOOR AREAS - REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGdT. 19 FIRST: 1,098 of BASEMENT: 0.00 of LEFT: 16 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,276 of GARAGE: 671 of FRONT: 10 PARKIIIG SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMFNT: 0 of RI[HT: 17 VALUE: $177,638.11 OCCUPANCY GRP: R3 BDRM: 3 OATH: 3 TOTAL: 2,374.00 of REAR: :17 _ PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: 0 LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAI,,S: 0 SEWER LINF:i: 100 SF RAIN DRAINS: 1 CATCH BASINS: 0 TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: 0 OTHER FIXTURES: 0 MECHANICAL _ FUEL TYPES FURI4<100K: 0 POILICMP<3HP: 0 VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN—100K: 1 UNIT HEATERS. 0 HOODS: 0 OTHER UNITS: 1 MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 0 WOODSTOVES: 0 GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UN' _ SERVICE FEEDER TEMP SRVCIFEEDERS BF, CIRCUITS MISCELLANEOUS__ AOU'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 0 200 amp: 0 W'SVC OR!-DR: I PUMPIIRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 5005F: 5 201 400 amp: 0 201 400 amp: 0 1st WiO SVCIFDR: 00 SIGN/OUT LIN LT: 0 PER HOUR: 0 LIMITED ENERGY: 0 401 - 600 amp: 0 401 600 amp: 0 EA ADD'-BR CIR: 0 SIGNAL/PANEL: 0 IN PLANT: J MANU HM/SVC/FDR: 0 601 - 1000 amp: 0 801+amp@-1000r 0 MINOR LABEL: 0 1000•amplvolt: 0 PLAN REVIEW SECTION Reconnect only: 0 >=4 RES UNITS: SVCIFDR>=225 A.: >800 V NOMINAL: CLS AREAISPC OCC. __ ELECTRICAL•RESTRICTED ENERGY _ A SF RESIDENTIAL. B.COMME170AL AUDIO&STEREO: VACUUM SYSTEM; AUDIO&STEREO: FIRE ALARM: INrERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTnUMENTATION: MEDICAL: OTHR: HVAC: DATARELE COMM: NUF.SE CALLS: TOTAL 0 SYSTEMS: 0 Owner: Contractor: TOTAL FEES: $ 4,988.60 This permit is subject to the regulations contained in the RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code,State of OR. Specialty Codes and 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work will be done In WEST LINN,OR 97068 WEST LINN,OR 97068 accordance with approved plans. This permit will expire 9 work is not started within 180 days of issuance,or if the work is suspended for mare than 180 days ATTENTION Phan@: Phan, Oregon law I equires you to follow rules adopted by the z Oregon Utility Notification Center Those rales are set Rm it forth in OAR 952-001-0010 through 952-001.-0080 You N may obtain copies of these rules or direct questions to OUNC I,y canlni, (503)246-1987. r � REQUIRED INSPECTIONS Erosion 84-i-8444 Crawl Drain!Backwater Electrical Rough In Insulation Insp Mechanical Final Footing Insp F'LM/l Jnderfloor Framing Insp Rain drain Insp Plumb Final w Foundation Insp Mechanical Insp Shear Wall Insp Water Service Insp Building Final J Post/Beam Structuralt Low Voltage A pr/Sdwlk Ins Plumb Top Ou g P p Post/Bea anIca Electrical Service Gas Line Insp Electrical Final Issu By : � � ._ Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bdsiness day / \ CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES i PERMIT#: SWR99-00067 13125 SW ball Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/11/99 Si i E ADDRESS; 14130 S1 . 116TH TERR PARCEL: 2S11013A-08300 SilDDIVISION: EVERGREEN SPRINGS � ZONING'. R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG TENANT NAME: RENAISSANCE CUSTOM HOMES USA NO: FIXTURE UNITS: 0 CL^SS OF WORK: NEW r)WELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: 0 Remarks: New SF - Path 1 Owner: FEES RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR _ - WEST LINN, OR 97068 FRMT DRA 5/11/99 $2,300.00 99-315265 INSP DRA 5/11/99 $35.00 99-315265 Phone: 557-8000 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection F- r ~ This Applicant agrees to comply wits all the rules and regulations of the Unified Sewage Agency. The per iit expires 180 days from the date issued. The total amount paid will be forfeited if the pemrit 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 LLJ shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and ' Side Sew&' Permit and the Agency will install a lateral. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: t _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day ITY OF TIGARD Residential Building Permit Application Plan ctyec"� 13125 SW MALL BLVD. Additions or Alterations Recd _ Date Recd — TIGARD, OR 97223 Sir,gle Family Detached or Attached (Duplex) Date to P.E. V 503-639-4171 Date to DST F 503-684-7297 Permit# wIP Print or Type; /rl Called -T,-/V 1,FC.7Z.- p Incomplete or illegible applications will not be ao ted — Name;f Project ---- -�-- Name Job �L�' '?H•1 '�'=' `r ' Architect Mailing Address Address Si�Address �/ rr 7/6 S I rD St./ JL 7�� City/State Zip Phone Name ,tea QW 97Z2--S 6-1y_ 0/SS 5 r..' '1�,^i r�' Na rde Owner Mailing Address lU,rn �/✓'/41•r F Mailing Address Y P Cit /State Zi Phone Engineer _ _- le -w -cr7- City/State Zip i Phone General Name Contractor Describe work New)K Addition O Alteration O Repair O Mailing Address to be done: Prior to permit I Additional Description of Work: issuance,a copy City/State 7_ip !� Phoneof all licenses are required if Oregon Const.Cont.Board Exp Date ren PROJECT expired in COT Lic# VALUATIONT _ (c _databyse mm y945 � /& — Mechanical Name NEW CONSTRUCTIONONLY: Sub- Sq. Ft House: Z3- Sq. Ft. Garage Address 7 C/ Contractor ailing desss _ �-- �. --- Prior to permit !34 S .SF- � Indicate the restricted energy installation by the electrical issuance,a copy City/State Zip Phone subcontractor in the following areas of all licenses 0„4 (C_m01 -7 S Restricted Audio/Stereo are required if Oregon Const. Cont. Board Exp Date Energy ___astem u Alarms expired in COT Lir,.# ��Il Installations Vacuum Irrigation _ database G77 Z(, 3_ g System System 1=!umbing Name (check all that other: Suh- C f-f /c ��,•+�/� aprr•�) ra u+' Iier loot YES NO Flag Lot YES NO Contra -or Mailing Address .,neck one) (check one) _ Sl �OJ ria.,the Subdivisiun Plat recorded? N/A �Ey� NO Prior to per.nit City/State Zip Phone .x issuance,a copy ,�, , ��j�JZ'ti• SZ �- Z of all licenses are Oregon Const.Cont.Board Exp Date required if Lic# / I hearb acknowled a that I have read this application,that the expired in COT 79C t!b 1���� y g pp database Plumbing Lic # Exp. Date information given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with 7 4 Z/.VgOregon State laws. _— - Name / Sigraty[e of Own r/Ager, Dat �Z E=lectrical s•e F/Pcf..,Y � Cont,.ct Person Name Phone# Sub_ Mailing Address s Contractor F() /3^X -z _ City/State Zip Phone Prior to permit issuance,a cony 97 ,;/S 6 S 7-a V` FOR OFF 'E USE ONLY: w of all licenses are Oregon Conct.Cont. Board Exp Date Plat#: Map/TL#: -� required if Lic.r' 31 5 y Z'I '1)1) '�)� D� `"1y1�&0 expired in COT 0 �_ r — database Electrical Lic # Exp bate Se ac 5: ne: Solar. I� L3 Electrical Supervisor Lic # Exp Pate ,; ngi eering Approval: Planni g Approval I TIF: i:\dsts\forms\sfaddall.doc 11/20/98 RIM.4 - EC -Z-7( esN 116 GIMf71%/./ RtJiCltq f I,u I I / (.-4t.-0 EL. 169.6�/ �9N4102. 0f S 9'1000" x o ZS"// EvR m8 PUBLIC TOR DRAINA E EASEMENT yjLn it � I rav,j' r3ioor'tt s '-S 5.00' I RM71 drM/MS SJ 7 - Iry o 01 v, Vl 28.17' c .83 Q.rfi Jr1If� [-( jg�„S 0 — i � , s "tp 6 SG - /90-/ (4 4 L 0 20.0' u I (t1 —� CP X5.0 ' OO -A `i 2. F FE 1--� 10.4 _ Stiff Ft"c Z F�� I I 0 r / ` ; t 0 EROSION CONTROL: 00' � 1 63' C3 0 v, DOTE: CENTERLINE CONCEPTS, ' 0 1.PROVIDE&MAINTAIN 8”(min)THICK SURVEYORS,WILL PIN ALL EXTERIOR N Q S 8 37.6' — c M GRAVEL PAD 6 DRIVE UNTIL FEFI�IANENT FOUNDATION CORNERS AND PROVIDE J 17' I CONCRETE DRIVE IS IN PLACE. SUBSEQUENT MORTGAGE SURVEY. W r 2.PROVIDE A MAINTAIN SOIL SEDIMENT FENCE AS INDICATED. PPUOLJC 5 NIIARY WEA EASEMChL1 N 910 00" E 02.00' ------_ �T MAP 2 2 1999 kAl'. er EL 2(9.� EL 177.S rt.tf. PLE / �AIfI�I Hr.A{I P•►. T�rMiMAI =•�' �` J� ( �.? LOT FS, EVERGREEN SPRINGS EL Zi*'t• '- Er. z b6 N.yll. 1l4 SEC.10,T.2S.,R.1W., W.M. ---AN 8 FOOT WIDE PUBLIC UTILITY EASEMENT —' SHALL EXIST ALONG ALL STREET FRONTAGE. CITY OF TIGARD I � WASHINGTON COUNTY OREGON MARCH 19, 1999 (--erlterIine Concepts Inc. DRAWN BY: PDS CHECKED BY: WGDIII SCALE 1"-20' ACCOUNT # 115 640 82nd Drive Gladstone, Oregon 97027 M: MLI\PLAT\L8EVERGS 503 650-0188 fax 503 650--0189