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11060 SW 121st AVE
INSPECTION NOTICE �\
City of Tigard Building Departaent
13125 SW Ball Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _— —
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gar Line )
Post/Beam strur_t. San. sewer Framing -Bdg.
J
Pont/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd.
Datj Requoated//: ' ! 2 ck Times AM —PH
Addrsei: Permit bs��` 1 (� 1
Builde.•_
THE FOLLOWING CORRECTIONSS APE REQUIRED:
i
Inspectors- --^� Dat / 7 -
� e•
_
APPRMD DISAPPROVED �pROVED SUBJErT TO ABOVE
�� call For Reinep.
SEE 35MM
ROLL # 21
FOR
OVERSIZED
DOCUMENT
CERTIFicA,rE OF'
CITY OF T IGARD OCCUPANCY
COMMUNITY DEVELOPMENT ART111411INT OF PERMIT #. . . . . . . : MST94-0157
IF DATE ISSUED: 11/22/94J
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)839-4171
';ITE, ADDRESS. . . g 11060 SW 121ST AVE
PARCEL: IS134CA-30616
,UDD I V I S I ON. . . . i ZONINGsR-4. 5
LOGIA.. . . . . . . . . . LOT. . . . . . . . . . . .
f,LASS OF WORK. sNEW
YVIE OF USE. . . sSF
1CCUPANCY GRP. v R3
ALCUPANCY LOAD: 119 4
i CNANT NAME. . . t
emav�ksi PATH I ADULT HOME
JINDSON PROPERTIES LTD
1 0 BOX 647
HILL.5SORO OR 971i24
Phoyie #: 640-1735
Contt-victut-s
WINDSOR PROPERTIES LTD
' '0 PDX 647
�ILLSBOR() OR 1371,24
Tone #: 640- 1755
..g #. . : 3;-'A14
(�cupavlcy of the above t-efet,el-wied building is hereby given, anti r_&)'tjfjeL
lie cc)mpliancp with the State Of Or-egos Sp(?cialty (:(ides for the group,
"cuijRncy, and Lisp unclev- which the r-efev^encecj ppv�m ' t wMOISSLIPIJ.
PUILDING INSPECTOR L
POST IN CONSPICUOUS PLACE
TUALATIN VALLEY FIRE & RESCUE
AND
BEAVERTON FIRE DEPARTMENT
• 4755 S.W. Griffith Drive• P.O. Box 4755 • Beavertan, OR 97076• (503) 526-2469• FAX 526-2538
May 13, 1994
Joe Brickell
Protech Fire Protection, Inc.
2901 S.W. 153rd Dr. , Suits 114
Beaverton, Oregon 97005
Re: Windsor Properties Ltd .
11000 S.W. 121st
59880-144-000
Dear Sir:
This is a Fire and Life Safety Plan Review and is .based on
the 1991 editions of the Unifcrm Fire Code (UFC) and those
sections of the Uniform Building Code (UBC) and Uniform
Mechanical Code (UMC) specifically referencing the fire
department, and other local ordinances and regulations.
Plans are approved as submitted, subject to the following:
Please call City of Tigard utilizing permit numbers as
necessary and their recording device to request inspections
prior to cover. Please provide 24 hour notification prior
to anticipated inspection times.
Approval of submitted plans is not an approval of omissions
or oversights by this office or of non-compliance with any
applicable regulations of local government .
If I can be of any further assistance to you, please feel
free to contact me at .526-2.502 .
Sinceer'ely, /
Gene Birchill, DFM.
Plans Examiner
GB:kw
cc: city of Tigard Building Department
"14'orking-Smoke Detectors Save Lives
PILU1-J.'ENG P'ER11.1T
CITY OF T I GARD 111 . r��,T,:,4 C� L
r.OMMUN!TY DEVELOPMENT DEPARTMENT DOTE ISE3L)ED.- 05/..-''4/94
13125 BIN HP.:j Blvd.Tigard,Oregon 97223.81 rata (603)639.4171 IS134CA-00616
4:*1 T E .. I I::-
:.) 1. A 1)1)R E.-S S 1.1.0 E,0 G W :1.2 1 S'l* 0 V
SUBDIVISION. ZONING: R-4. 5
---- -
(.'LASS OF WORK. . *.NEW UARI-40GE DISPUSAL.S.. .. :: 3.
fYPE OF USE. . . . -.SF WASHING MACH. . . . . . . :: 1 BACKFLOW PREVNT1*%'5'— .0
OCCUPANCY GRP. . :R3 FLOOR DRAINS., . . ,. —. ., :J?) TRAPS. -.0
STORIES. . . . . . . . al WATER HEATERS. —. . . .-. 1 CATCH
"i I X T U R E S- LAUNDRY TRAYS. ., » .. .. ., ::0 ISF ROIN DRAINS. . .
blNKS. . .. . . . . . . . : 1 GREASE 'TRAPS. . . . . . . ..0
LAVATORIES. . . . . :7 OTHER FIXTURES. . (d
TUB/SHUWERS. . . . - SEWER LINE (ft) . 0
WOTER CI-USE-Ts. . -'? WOTLR LINE (ft) -. 100
DISHWASHERS. . . . : 1 RAIN DRAIN
--onia-f-k.s: PATH I ADI. L. HOME
OWNERi F E E S------------
W I N 1)S ON P'RO 1%,E RTI E S LTD TIF $ 1520.00 13W 05/24/94
P 0 BOX 647 BPRT $ 463. 00 SW 05/24/94
B V,L L q; 300. 95 JLH 03/24/94 94 V)
HILLSBORO OR 9*x'124 rq5l",c $ 2.3. 15 13W 05/P4/94
i,hone #: 640-175.1i SSDC $ 280. 00 SW 05/24/94
PARK $ 500. 00 SW 05/24/94
1.k.1 III li i i1q. colit-racto-f, ...... 11PIRT $ 57. 00 SW 05/24/94
I11PLC $ 14. 25 SW 05/24/94
M5PIC $ 2.. 8SW 5 S 05/24/94
i-I d d-r e s%r PPR*T $ 192. 50 SW 05/24/94
i t y L a t e 5 P C $ 9. 6.3 SW 05/24/94
t.I p tt
-------------- P h a n e#
REQUIRED INSPECTIONS
FhiS PIPI"Illit iS iSSUed SUbject to the 'req ...
ulatioris contairied in the Tig,-vrd Municipal Foot/found Insp Rain d-r,.Airi Insp
,.ode, State of U-(,e. Spv(:,3.,AJ.ty Ladei.-* and all Post/beam Strurt Water Lj.rie Insp
,:)ther applicable laws. $4.1.1 work will be done Post/Beam Mechan Appi,/Sdw1k. Insp
in acco-(•dam:.,e with app-t,oved pi(7.kiis. 'Thi.s P) m/mid s lab Iiisp llechai)ical Final
pey,mit will expire if work. is riot -started PLM/Ui-tde-(,f loor Plumb Final
within 180 days (if issuance, or if work is Mechanical Insp Building Fiiial
liuspended for more than :180 days. F."lumb Top OL(t Erosion Control
1--1,4A III i)-I q I I)1.-,1.) Crawl D-t•aiii
Fireplace Irisp
Gas Line Insp ....... .........
Ivisulation Insp
Gyp Boa7,d Insp
'Attho'M air-P-Vt0(b:rP-F7o tit-- urator Signature
GAIi for inspertion -- 6J9-4175
a n t-r a c t a-t, N o t e s tt
...............
CITY OF T I GARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPA PERMIT #. MS 194-015""
(,O�
4TVF
.VT 05/E4/94
13125 SW Hall Blvd.Tigard,Oregon 97223-Sli* 171 DATE ISSUED:
PARCEL: IS134CA-0061.6
S IT E A D D R L S S » « e 1 .1-0 6 V) W I i-'2 15 F ZONING: R-4. 5
SUBDIVISION
—— --
BLOCK. .. .. . . . . . . . .. ..
BU I L D I N G .........
REISSUE: DWELL I Nu UN I TS: 1 BASLIIENT. . . . . . . . .0 f
ULP159 OF WURK. oNEW BEDRMS.-5 BATHS-.7 (3ARP.Uj . . . . . . . . . . ..370 -f
I'YPL OF USE. . . :SF FLOOR REUUIR14'-D SE*Tt.'iACKS-------------------,----
f YVIE OF' CONST. u5N FIRST. - - - :2285 Sf LEFT. . : 16 ft RIGHT. -.10 'I'A',
i:TCCUr FRONT. :23 ft REAR. " :87 -Ft
-1ANCY GRP. r�.3 SECOND. . . :0 ta f
STORIES. . - .. - - - -' I THIRD. . . . .'O Sf REQUI
H L 1 G 11 T -- 19 f-L T'O'T'n ----------:2 2 8 5 Sf SIJOKE DETE(.TORS. :Y
FLOOR LOAD- - ;40 ps t VALUE. . .. . - $11 PARKING SPACES- - : 1
I ADULT HUME
PLUMBING
FLUOR DRAING. . . . 10 BACKFLOW P R E V 11 T 0
.,AVATORIES. . . . . :7 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
IUB/SHOWERS. . . . 12 LAUNDRY TRAYS— :0 CATCH
WATER CLOSETS. . :7 SEWER LINE (ft) . 10 GREASE TRAPS. - - -0
DISHWASHERS. . . . : 1 WATER 1-114. ( ft) . : J.00 OTHER FIXTURES. . 0
GARBAUE' DISP- - - I I RAIN DRAIN ('ft) - W
WASHING MACH. . . a1. SF RAIN DRAINS- - I
MECI-IANI(;AL F EES
UEL U N IT H T R S,. . :0 type Anlot.ti-It by date re pt
, GAS/ VENTS . . . . . :0 *YIF" $ 1520-- 00 SW 05/24/94
1AX INPUT:@ BTU V EN T F A N S. . :8 BPKT $ 463. 00 SW 05/24/94
URN < 100K . . :0 HOODS;. . « . . . 21 BF11-C', 1; 300. 95 JLH 03/24/94 94-2."0476
: URN >=100K . . -. 1 WUUDSI UVES- :0 14 5 P I., $ P13. 15 SW 05/24/94
LUUR FURN. . . . 10 CLO DRYERS. : I SSDC' $ P80. 00 SW 05/24/94
P 0 OTHER UNITS: 1. V,1.1 R I's $ boo. OW SW 0t)/e4/94
GAS OUTLETS al 11PRI $ 57. 00 SW 05/24/94
........ III P L(", $. 14. 21; SW 05/24/94
,AINDSON PROPERTIES L.TD m 5 P G $ 2. 85 SW 05/24/94
0 BOX 647 PPRI $ 192. 50 SW 0".5/24/94
9.6j SW Oto/24/94
IILLSBORO OR 9*7124
'horse #3 640- 1*/bb
'ovit-racto-rc ..........
JINDSUR PROPERTIES L*TD
,C) BOX 647
1111-1-SBORO OR 97124
11haiie 0: 6,40 1.755
Reg 0- - 2 52014 $ ;3;363. 33 TOTAL.
Thispersit is issued subject to the regulations contained in the REQUIRED INSPE.C11UNS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foat/faurid Insp Fi-replace 1Tis p
applicable laws. All work will be done in accordance with approved post/Beam St-rUrt Gas LJ-iie Irisp
Dian. this pervit will expire if work is not started within 188 posit/Beam Ilechaii Insulation I 11S P
days of issuance, or if work is suspended for sore than I d Plrn/undslab Iiisp Gyp Boa-rd In%p
FILM/Underfloor loor Rairi drain 111 S1 p
J:,C.�r m i t-I-e e S i q i ta t I.,'re-- -X-- ;Z.:�>"1. R, MeehaiiJ.eal. Irlsp Water Line 111SIP
Plt.tmb Top Out Appr/SdwlE% ITIsp
RY3 F-ramirig Trisp Mechanical. Fi.rial
Ca'11 (ot, irm.Lpe--timi --- 639-4177)
SEWER CONNECTION
CITY OF T IGARD P E R rl 11
COMMUNITY DEVELOPMENT DEPARTMENT P E R 11 IT #. . . . . . . .. SWR94-13160
13125 SW Hall Blvd.Tigard,Oregon 9722398111114;(603�6i-41711 11
LATE ISSUED." 05/24/94
PORCEL: 1S134CA-0061E,
S IT E A D D R E SS. . » : 1.i06Ld ',iW ZONING: R-4. 5
I
SUBDIVISION. . . . :
FLOCK. . . . . . . . . . : 1 01.. . . . . . . . . . . . .
-I--.............
LNONT NAMV'.-.- . ., . .. „ FIXTURE UNITS. . .
.ISA NO, . . . . . . . . .
L DWELLING UNITS- - : 1
' OF' WORK, :NEW
AS"i NO. OF BUILDINGS: 1
OF USE . . . . .. . :SF IMPERV SURFACE— : f
TYPE. .. .. . -E41JSWR
PATH T ADULT HOME
. .........
type amot.0% date -recpt
JINDSON VROPERTIES LTD type.` $ 220(1.00 S W 05/24/94
U L4(JX 64 1 INSF' $ ;3!a.00 :3W ob/P-4/94
'111-1 SBORO OR 913.24
qj()1-je #-. 640-1755
i.,c)iitrac.-tul".
(.:UNT+'(-)(.J0R NOT ON FILE;.'
$ 2235-00 TOTAL
(j)-i e ff
1:'tL'(4UIRED I N S PE CTI 0 N S
This Applicant agrees to comply with all the rules dna regulations —-------
of the Unified Sewage Agency. The permit eipires 180 days !roe •---•-- ----
`,he
-------
the date issued. The total amount paid will be forfeitpd if the ....... —•.-•--.........
permit expires. The Agency does nct quarAntee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the instc,lIeT shall prospect 3 feet in all directions from
ttoe distance given. if not so located, the installer shall purchase
a "Tap and Side Sewer" Persit and the Agency will Install a 41..,te 41.
...........................
-r ni j. 4 .. ......
t Lt
ti U E3 d !'.1 y ..........—.......... ......
c',all fur :i.1-1spectioll (r.39—.417'5
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 /^ LI IV, S
5; 3�lelq 414
Jobsite Address-0-
Subdivision:
ddressSubdivision: Lot
0 4) Office Use Only
Valuation �77 ,{#�� � /�� 7 U - Plandc/Rec # `� W.5t/
/ Permit # �
Owner: <��J//v r c>>Z �,y�Lr->-77 (�� C.�% Reissue of
Address: I?��� - � � -- Map & TL #_� ��L�J4
Phone: - L2
17 Approvals Required
,�
/ ) Planning, .(I 1/lwez-
Contractor: �C/�!v!J' �) r�.Y-7 P7 rl4f, L 1 Engineering _
Address: .7 0 ) Other
/ r` items Required
Phone: � l , ac�
Contractor's License # _ j d 1 Q�(F .� ��Subcontractors
(attach copy of current Oregon license) Triss Details
9 _ r I � 't' --
Subcontractors:
— -- ---
Subcontractors: �9`{�` `�33 1 �}( �' X109 , '
Other
Plumbing: J-4 -t -
> _ I
Mechanical: f
(attach copy of current OR Contractor's License)
Architect/Enpineer: 7 e) Lj _
Address: _� / itj '
Phone: D-
COMMEN'rs:
Applicant Signature & Phona M mber J
L,
Received by: Date Received: ,,2 c� • ljc,
Permit # Account Description Amount Ar,it. Pd. Bal. Due
0!.S Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) �l� ✓
Mech. Permit (MECH)
State Tax (TAX) .3 f,W 3 ✓ _ 3�.lr r�
Bldg: /
Plumb:
Mech.-
Plan
ech:Plan Check (PLANCK) 3�5 � ��(J� G s' ✓
Bldg:
Plumb: /
Mech: t ✓
/'q - c l l �' Sewer Connection (SWUSA) G l' Z� Gy
Sewer inspection (SWINSP) -> > S
Parks Dev Charge (PKSDC) _S�� 5�� ✓
Storm Drainage Chg (SDSDC) , L�-v
Residential TIF (TIF-R) / u
Mass Transit TIF (TIF-MT) x,10
Commercial TIF (TIF-C) _
Industrial TIF (TIF-I)
Institutional TIF (TIF-IS) _
Office TIF (TIF-0) _
Water Ouality (WOUAL) _
Water Quantity (WOUANT)
Fire District (FIRE) 5 34r.
_
TOTALS:
J