14430 SW 128TH PLACE 14430 SW 128"' Place
our
C`TY OF PGARD Inspection Line: 503` 659-4175 S
BUILDING P ( 1MST
INSPECTION DIVISION Business Line: (505)F39-4171
BLIP _--------- .— -
Date Requested /_ * �'-- -- AM-- ---- PM --- -- BLIP
Received ____ ---- G
—? -- --- _---SI lite_—._— -- - MEC
Location l 44-'3Q�%—i 1 e - --- -- ----
Contact Person Ph (___--) __— ----------- —
PLM
ContractorPh(----) SWR ----_--_-------_--- --
BUILDING
Tenant/Owner
— — -------- - — EL -----
Footirg ELC -
FoundationI Access: ELR
Ftg Drain
trawl Drain - - SIT
Slab Inspection Notes:
Post& Beam
Shear Anchors
Ext Sheath/S:ir it -
Int Sheath/Sht ar - -�
Framing i
i �w fit atl�L ��� /—'fie -
Insulation —
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ce"ing ---
Roof -.. -- ---.
Final
_ PART FAIL
PLUMBING --
Post&Beam
Under Slab
Rough-In
Water Service - —----
Sanitary Sewer --
Rain Drains
Catch Basin/Manhole -
Storm Drain
Shower Pan - ----
Other:
Final
PASS PART FAIL
MECHANICAL _ _—
Post&Beam -
Rough-In — --
Gas Line
Srr.oke Dampers -
Final
PASS PANT FAIL
-
ELECTRICAL
Service
Rough-In - --
UG/Slab
Low Voltage - --- -
Fire Alarm
Final Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
Unable to inspect- no access
SITE _ Please call for reinspection RE:-________—__._-__- --
Fire Supply Line
ADA DOW C' Inspector ------Ext
Approach/Sidewalk
Other.
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 �_MST d�a G 5
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _ Date Hequested_ — 3Y6_AM PM--_ BUP
Location _- 3�-� ZC — Suite MEC
Contact Person _ Ph( ) ^ jam' 1�U`:� PLM
Contractor _ _ Ph( ) — _— SWR
BUILDING Tenant/Owner _ ELC
Footing
Foundation Access: ELC
Ftg Drain ELH
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors
Ext Sheath/Sheai
Int Sheath/Shear --
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ----—
Fire Alarm _
Susp'd Ceiling — - _—
Roof
Other: s�—
Final
PASS PART_ FAIL --- — -- —
PLUMBING
Post&Beam � - -- -- -- --
Under Slab
Rough-In
Water Sery :e
Sanitary Sewer
Rain Drains ----- -
Catch Basin/Manhole
Storm Drain — -------------- —
Shower Pan
Other: — - ----- ---- —1/'PAS.,jy PART FAIL
NANICAL_ _
1'ust&Beam — -
Rough-In ----- - - --- —_ -- —
Gas Line
Smoke Dampers ------ ---- .-- -- __, _
Final
PASS PART FAIL - --- ----- --ELECTRICAL
Service -- — -- --- - - - --- - - -
Rough-In
UG/Slab —_ -----------___--- —.
Low Voltage
Fire A!arm -- ----- - --
Final F1 Reinspection fee of s __- - required before next Inspection. Pay at City HRII, 13125 SW Hall Blvd.
PASS PART FAIL
SITE_ n Please call for reinspection RE:. F-] Unable to Inspect-no access
Fire Supply Line
ADA �
Approach/Sidewalk Dab__��� Ip%paoter _ itxt
Other:
Final -- DO NOT REMOVE this Inspection record from the Job 11 Its.
PASS PART FAIL
CITY OF TIGA,RD 24-Hour
BUILDING Inspection Line: 503) 639-4176 MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received _ Date Requested—AM PM BUP
Location _. '?.,-epi Al/ -
Suite MEG _
Contact Person ph( _) �3 ���5 PLM
Contractor __— -- Ph( ) - SWR —. - --- - ----
BUILDING -- Tenant/Owner — — ELC
Footing -. - - --- --
Foundation Access: ELC
-- --
Ftc,Drain �:- �r�
Crawl Drain ELR -- - ---- - - ---
Slab Inspection Notes: SIT
Post&Beam --
Shear Anchors
Ext SheathiShear
Int Sheath/Shear - -----
Framing - - ----._--
Insula"• - --
Drywa.,wailing
Firewall , �, --
Fire Sprinkler - d7- 2 e Y
Fire Alarm — —
Susp'd Ceiling —
Roof
Other: ---
Final —
PASSPART FAIL -- _ - ---- _ —
Po at - ---
Un lab
Rouah In -WE Service
Sanitary Sewer - -
Rain Drains - .. �_ --_------ -
Catch Basin/Manhole
Storm Drain -
Sh r Pan
off
_PASS PAT FAIL -
-- ICAL -
-- -- --
os earn —
Rough-In
r-,aa Line
smoke Dampers
,Final -- ----- --
A RT FAIL - -- - -
socwre._ - — — -
Rough-In
UG/Slab - - - - -
Low Voltage
Fire Alarm - — --
Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS ART FAIL-
511 1h _ ( Please call!or reinspection RE:- Unable to inspect.-no access
Fire Supply Line
ADA
Approach/Sidewalk Date--r—� - - 1Jn ector -
Other: __
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
`• l +' _ ! _ �T t " �" Irl �/�7
�
w ��u MASTER PERMIT
CITY OF
T I �GA ,D -7 i�u�t,� f-)L- PERMIT#: IJ�ST2002-00235
DEVELOPMENT SERVICES DATE ISSUED: 6/5/02.
13125 SW Hall B v , OR 97223 (503) 5Jy-4171
SITE ADDRESS: 94830 S1fJ 1 PL PARCEL: 2S109AA-05700
SUBDIVISION:' FLK HORN RIDGE ESTATES "' 'LING: R-7
BLOCK: LOT:023 JURISDIG: ION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: STORIES: 3 FLOUR AREAS REQUIRED SETRACKS_ REQUIRED
CLASS OF WORK: NEW dE'GHT: 20 FIRST: 1,480 at BASEMENT: 922.00 at LEFT: 5 SMOKE DETECTOR 3: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 2,182 et GARAGE: 702 at FRONT: 20 PARKING SPACE.3: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: of VALUE: $452,979.80 RIGHT: 10
OCCUPANCY GRP: R3 BDRM: 6 BATH: 5 TOTAL: 3,662.00 of REAR: 22
PLUMBING —
SINKS: 3 WATER CLOSETS: 5 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 8 DISHWASHERS: I FLOOR DRAINS: 1 SEWER LINES' IN SF RAIN DRAINS: I CATCH BASINS:
TUBISHOWERS: 5 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: '0,, BCKF LW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K BOIL/CMP<3HP: VENT FANS: 7 CLOTHES DRYER. i
GAS FURN>•1OOK: I ".0T HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: hW FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RCSIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERF — BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 - 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 50CSF: P 201 •400 amp: 201 •400 amp• tatWlO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 -600 amn: 401 600 amp: EA AUUL i.:'fNR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC/FDR! 601 - 1000 amp: 801+ampa1000v: MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect on' >•4 RES UNITS: 9VCIFDR>•226 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO J!,STEREO: VACL''JM SYSI EM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: MVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAlTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 9,489.84
This permit Is subject to the regulations contained in the
PAUL CARNEY INC PAUL R CARNEY INC Tigard Municipal Code,State of OR. Specialty Codes and
1480 NW 102ND AVE 1480 NW 102ND AVENUE all other applicable laws. All work will be done In
PORTLAND,OR 97224 PORTLAND,OR 97229 accordance with approved plans. This permit will expire If
work is not started within 180 days of Issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rea r: t IC 56852 forth In OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 84 Post/Beam Structural PLM/Underfloor Electrical Dough In Gas Line Insp Appr/Sdwlk Ins--
Grading Inspection Post/Beam Mechanics Ftng Drain Bsm't Walls Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing Insp CraWI Drain/Backwater Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Foundation Insp Fooling/Foundation Dr; Electrical Service Low Voltage Water Line p Final Inspection
Issuod By : � I '' Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day
tz, iyy3Z)
CITY OF TiGAR® SEWERCJNNEC'I'ION PERMIT
PERMIT#: SWR2002-00156
DEVELOPMENT SERVICES DATE ISSUED: 6/5102
13125 SW Hall I rd, OR 97223 (503) 639-4171
PARCEL: 7S109AA 05700
SITE ADDRESS, 143`30 S 128 Fi L
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7
BLOCK: LOT: 023 JURISDICTION: TIG
TENANT NAME:
SA NO: FIXTURE UNITS:
U
CLASS OF SA NO: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL T,'PE: LTPSWR IMPERV SURFACE:
Remarks: Se\er connection for new SF. _—
Owner: — --- �_. FEES__
PAUL. CARNEY INC Type By Date Amount Receipt
1480 NW 102ND AVE
PORTLAND, OR 97224 PRNT CTR 6/5/02 $2,300.00 772002000,30
INSP CTR E/5/02 $35.00 27200200001)
Phone: .503-297-9406 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections _
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date Issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet In all directions from the distance given. If not so located,the Installer shall purchase a"Tap and Side Sewer" Perm
` Permittee Signature:
Issued by: 2 ,-._ / 1' --
Call (503) 639-4175 by 7:00 P M. for an inspection needod the next business day
- 11l, vv.,o rt.n aviavoiaou CITY OF TIGARD 0 001
A . X15 .
]Buil�ding•PermitAppJf'cation �~
Daterece:ved: r ? �'� permitoo.:�'lf' . Q�
C"�J t Iii Tigard Projeet/appl.no.: edate!
Address; 13125 SW Hall Blvd.Tigard,OR 97223
City ofTieerd phone: (iO3) 639-4171 DauiseueG, _W By: / Receipt no.:
Fax: (50;)598-1960 *'�.A 1 t , Case Gee no: Paynlenttype:
Land u: approval, `�' � r I$?f�nuly Stm`�e Complex: �`
*("w conctntrtjon L.)oemoiition �
'I �2 f4miiy dweilini or accessory ❑CommerLi^.Uutdustral J Mulu-family Ulii�
4ddluon/alteratiordre lacement. J"Fenant improvement U Firr sprinkler/alarno J Other.
J. Z Bldg.no.: S•aite no.: U
Lot: Block• iSuhoiviSion: 4 //' /�rt.� Tc, t t __ sj Tax map/tax lor/account no.:
1'rojva name:
I)escription and location f work on premises/special conditions:_ /V
Name:
Mallin address: v 1&2 family dwelling: s s1 77,-,
City: -' Stem: ZIP: ;L Z Valuation of work.......................................
c
phone: ) t/�6 Fax: LyG r6�1 l.�meil: No.of bedrooms/baths................_.....
Owncr's mptesentatiVe: .�_ C Total number of Hoofs.................................
r T S- i'az: r[, Y6a f Email: New dwelling areas ft ......... y E y
Phone: '. ( q. ) .................
Gamge/carp,)tt arta(sq.ft.)......................... _
Covered porch area(sq.ft.) . •••
Name: S C` �--
- Deck area(sq.ft.)................. .. ....... _� 1-
Mailing address: — Other structure area(63.ft)••••,....................
City: State: ZIi':
' E,-mail: t:ommes�riaUindos�triaUmta
ultl- miiyt
Phone: �I"ax: Valuadon of ......
work.............. .. S
Existing bldg.area(sq.!i) .......................... --
Business name: ` c' New bldg.area(sq.ft.) -
Addreas: Number of stories....................................... _
City: State: I ZIP: Type of construction.................................... -- —
Phone. Irax: Frmail: Occupancy group(s): Existing: ._
CCB no.: New:
City/metro Itc.no.: - -- 711 contractors and subcontractors are required u�be
ith the Oregon Construction Contrictors Board under
s of ORS 101 and may be required to be licensed in the
jurisdiction where work is being performed.if the applicant is
Address: i� / :xemp:from licensing,the following reason applies:
r T -. State: ZIP: 7.2'
Contact .rsten- n- n��r'•t Plan no.. �) /.�'/5 _ _ _,
Phone: L `1 iG I tax:7 t 7?.; &mail:
// 4 ,,►sContact Person: ��� Pees due upon application ...r...................... $
Name: u — bate received:
Amount received..-
State: - �, �� � .......................................
ZIP: S_
�� T'a /'► &mall: Please refer to fee schedule.
Phone: ti -G y 'ax: —
,N/�,W�.Jtalediraea tteotOt credit card].P 0 can ieriedktlea for heals IaWMI Woo.
I hereby cerdfry I have mu and examined this application and the N In O aft woCud c t[
snatched checklist.All pro- Isions o awa and ordinances governing this C�M01) aaatbcr• . Uue Zr�t,yu
work will be complied t; epe�ifled here r not. _ "-
1 Due: ----� a NeWO N C 1•
Authorized signature: llY mal
Print name: / �r-/ G '� —� `-I -- - - e
1404613(WWCOM)
Notice:This permit applieatif 1 expires if a permit is not obWned within I So days after it has Coen accepted as nom
I
vo,u1/4uu4 va:ia I-All, 5u35981960 CITY OF TTGARP Q002
glee tric l Permit Application
pDatcr=eived: C 0 Pu,dtno.:l ,n0
City A Tigard ProjecU+ppl.no.: EsNiri late:
Ciryo(Tlgard Address 13125 SW Nall Blvd,Tigard,OR 97223 Date issued: - iiy Rcceiptno.
Phone: ('03) 639-4171
Fax (50 1) 598-1960 Case file TIO.. Payment type
Land u!,r approval:
!� I Bc 2 family dwelling or accessory 0 CommerciaUindusuial 0 Multi-family :r,�ant improvement
O 1' v construction D Addition/altcrntion/replact mcni D Other. _ ial
I�� INFORMt
lob address: Bid .no.! Su;te no.: Tax mapAax loVaccount no..
Lor. Z Block: Subdivision: `i
Protect name: t.�T Z D.scription and location of wori<on premises: Ai I
Estimated date otcom lesion/ins ertion: o
TION
t Job no: G •� :3
7177
USi0e55name: - Newneidenrfal-cinglearroula-r+mtlyp
Address: Z I �� r C,_C( dmirviewut.lncludrsettmctrdprace.
City'. C� •1i, S�:VL ZIP: v Scrviceuscludcd:
1000 sq.A.or lets
Pho,ie Yrz -I/G Fax:666 a83v ma11: Enchadditional 5oosq.ft.orportion thereof
CCB lio.: ����7u FICC.bUS.lit.D0. Limitedene,; residcnual a
�1ty/frier ]i O.: Limited energy,non-residential _ 2
Each manufactured home or modular d,velling
"•'— D+te
Service and/or(ceder ___ 2
S,gnf of f electri:ian(requirtd) r--- Services or feederv-Itutellslion,
sup.e .name(print): I I(Arense no: alteration or relocation:
200 2
1
�-j. ��f�c 201
amps a TWO cops 2
Name(print):_ �`� t C 401 amps to 600 e s 2
Mailing address: U i Z" 1?` 601 am s w 1000 a•nps 2
' —�T A- State-cP— ZIP: .7 Over 1000 am %or volts 3
City:
Phone: - �6 IRsx' 2 Y Y G k I islrail: Temporary
_
TeerHs'ae o►feeder^-
Owner Installation:The in:inl)ation is being made on property I owninstallation,allerstten,erteleeluoe:
which is not intended fol:ale,lease rat,or exchange according to 200 amps or less _ 2
ORS 447,455.479.670,"01-- !01 amps to 400+mps _ 2
OrA
' sinature: _
/�Dge:el S 66 ` Z 401 to 600 ams 2
nnsteh dmits-stow,attention,
or extension per panel:
A Fee for branch circular with purchaseoservice or feeder fee,Tach brunch circuit 2
__- Stere: Zip: B. Fee for bench ciruiH without perchtue2 of service or feeder tae-tint branch circuit:PhOoe: 'ax F-mail' Eaeh+ddlNonalbtanchcircuie _
14Mlot_(Servke or leede�eon Included):
bac,)U-mp or illation circle
7..
iceover 225 unps cc max:al O Haar,Cali,W1111y 2
Fieh si m or outline li hung
iceover320+mp+r+Ungrl'Idd OHazardousloc+tionSi nalcireun(s)oralimitedenergypnnelydwdlings O Building over 10,000 square Poet four or sherstion,or esten+ion• _ 2
more residential units in one evucture —� --1---
O System over 600 volar nominal
O Building over Uva stories O Feeders,400 amps or more •Ikscripuon: - ..._
O fkcupann load over 99 persons O Manufactured structures or Rv park F,ach additional inspection over the ullonwble In any of tlr above:
nEgrees/liandngplan LlOdtee — Prrinspec.tion
Submit—_ :ear of ptsoa with say of the above, 111-1 dation roc —
Tin above are wt NPI,litablr to tem construction aWke. Other
_ Permit fen.....................S --
Nr4 d111Y1 iaee aorepr arenas tard plow call Jrlr)wacrim ra more Irtfattnalioe Notice:'This permit application Plan view(at %) $
expires if a permit is not obtained State surcharge(896)....$
0MU U Mul"Cott i �5 _L (,U'4v Gt t 7 r� I within 190 days after it has been g
TOTAL .
oedit e"r�-�era L .,.. spin, +ceepted as complete. ......................$
'so s r Cold 1
1+44615 16V 10M)
die AmeYM
11 .1 vaviaov 1.111 Ur 116AKU 10004
Mei.ItAit< a Vermit App➢i :a ion
- - - - Date rccelvsd: 7 e 7' Pamir no.: '(JDc��
Clay f h ' aril project/appl.no.: Expire te.:
C. n and Addreft: 13125 SW Hall Blvd,Tigard,OR 9"223 r 11
r'7 �� Date issued: By:j, t Receipt no.:
Phone: ( Q3) 639-41'11
Fax: (50.) 598-1960 Case file no.: Paymanttype:
Land u: C approval: _ Buildingpernut no.:
�I
TYPEOF
=.2 family dwcllin, or accessory U CemmemislAndustrial U Multi-family U Tenant improvement
ew construction 0 Addition/altcrauon/replacen ent O Other. ____
1 1 I. 1 1 1 1 1 —
Job address- t; S /'Z Y t• l... Indica a equipment quantities in boxes below Indicate the dollar
Bldg.no.: _�_ Sulte no: value of all mechanical materials,equipsi,:.nt,labor,overhead,
Tax map/tax lot/account ro: profit. Value$ _._..
of; ISubdivision. f "See checklist for important application information and
Project narrte: jurisdiction's fee schedule for residential permit fa
City/county: ,,o r/� �.! 1�,, ZIP: y i ? y '
Description and ocl ati6n A work on Oemises: 1 1 1 1 t t
Fre(M) Total
Est,date of completion/it spection p Bcuiiptiuu . Res.only Ra.only
Tenant improvement or c Lange of uee: /U �? A h .:
Air handling unit _ CFM
Is existing space I atcd or condihoned115' U No pjicondltio�-T(sitse plan required) _
Is existing space i'tsulatui?O Yes U bio Mention of exiying_ VAC system
1 1 oils/compressor �—_
Business name: `_/ :d Z- ,�• ('oo . State boiler pernvt nu.
_ ftp Tons DTIJ/H
Addrrss: v/Z S w Z e iioltmolcc damput/duct smoke detectors
Crty G .y e� e: ZIP: /Z at ump(slue plan ui�
Plwnc: r l$ SGZ U I Fax: Email: Instal replace furnacelburner .
fncludirgd:,t,:wrwk/ventliner OYuUNo
_ nsla lace/mlocareheaicrt"-tut ended.
City/metro lir.no.: -wall,orfloor mounted
�� Vmt Drop 6ancc-�cr thin furnace
Name(please q: �' -
+ ` iSi=crywt►u
Mot Absorption units BTUM
adllrrs _ _ ___ 14P
Name: A../ 7 r� rem .eusan lip -
Address: /�1 h't) /V w o fr r .rA-�TMtha�uai and/w�iattuu:
5tme;r r 1. ZIP { cl_ Appli/nct vent _ —
I'hOne: aexhaust --
r
71 W T*ImTru.k1was=W-
hood fir.:tupptessinn trystem
Name: c_ ��` PWutust fan with tingie duct(bath fans)
Mailirllr,arlchxsS:
Exhaust s titan�a+art 6v .air
ng ar
pip aua�ut Idl0r up in 4 oU e"
UCi _ State ZIP: Tye (pc7 „ NO Oil
p��• Fax: &mail: !'ue� ea
piping e t 0 over a'1 ilea
- - -
Wp (fe eelemabcrequired)
Number of)utters
Name.: — — Tt'°..•�� /� ...v.....c� + -her ap uce or e�gdpna�lt; -
`' ---
�1c De4orattveCueyIs" _ --
insert-type
at - - F G.ruil' �oodFmv Ire U clove
Pltiunn• ' _
Applicant's signature: Date ci tier
N"�rinU -
►+.a l
r41 r a.,pi ew Derr l.a+aiealea far iahtsatwa pe t mit fon.....................8
laryw U Mast :Douce.This pnmMi
ir application $
- _
tilmwtl fee............. ..
ofv cat t U Ma (�+ "1 r...' expims if a permit is not obtained Ilan inview(atChWlS _-
. , . within 180 da)-t after it has berm _-" --
■ ne« c `� auocpted as mmplete 5 aurhatEe(896)....s
T 'AL.......................$
AMNON
4"l7(title"
(,rtr ur 11GARD 009
Phu iibing Permit Application
IDatFerc-ccivcd. A i%% permit no.: '�fp�gpa Dll�u
City >'f Tigard ----�
Sewer pertnn no.: Buildingpermit no.;
Address 131"25 SW Hall Blvd,Tigard,OR 97223 ------ —
CirvnlTrgarrf phone: CiW) 619-4171 Pro)ecdappl.no. Expiredate:
Fax. (5C'-) 598 1960 bate issued. By- Receipt no..
Land u. a approval. Case Me no. Payment typo:
1 12 OKI]a 10
,Kl I &2 family dwellint or accessory ❑Con-tmr;rclal/industnal O Multi-family Q Tenant impmvernent
1•New consuucaon 1]Addition/alteration/replacement ❑Pood smice L-)Othcr.
1 t1.11MNFORAIATJQNt
Job address: ;Z > DescHption Qly. Fee(ea.) Total
Bldg.no.- _ _ Suite no.:
New 1-tnr'2-Cunily dwellings only:
Tax map/tax lot/account t-3.: (includes 100 H.for each utilityl.onnection)
r SFR(1)bath _
Lot; 2 Block: Subdivision: 1411.., 2� SFR(2)barb
Project name: _ _ STV )bajh
City/county: 7-/ z h a d noonal ba-dUUtc'ten
Desai on and I ation, f work on premises: 7E— I Siteutilitles:
-•9� /f-�-L__ Catch basi /area dram
Fat.drte of^ompletiontin pectien: Drywells/leach lindtrenrh drain
t 1 1 111111111113111111 FOntia?drain(no lin.ft.) _ -`-
Manufactured home udlities�
--
_ Manbo es
Rain drain,:ounectot
City, -0--3A, t 41VI&A State:('p? "r_ .7 SarutAry scwcr(no.lin. t.) —
Phone. 3//a - y 7f !lax: l?-malt: Storm sewer no.Un. .
CCB no.; .a S 5- Plumb.bus.rag.no:311-Z 7. ater service no.lin.ft.
CI /metm lie.no.: Fixture or item:
Conttactot's ro resenudve al : �___. Absorption valve -J
Back flow preventer
Print items; �� Date: _ =o z Backwater valve �^
Basins/lavatory _
Name: C o ec washer _-__-
---— �. u L
Dishwasher
Ad_drers: n fount s,
City: f, State:G 71P: 7 Z�. 9 Eieclors/sum
Plwna; z 7 1. 0 rax:1 y( y' J E-mail: Expansion tank
ixtutelsewer cap _
�dw7`` , Floordrains/floor st to
None(print): �r , _ Garbage •'sposal--
Maillag address. Hose bilib'—
City; State ZIP: Ice iMer u
Fhone• +�;nx: &mail: tette tor/ ase crit
Owner installation/residenb,t) maintenance only. The actual installation Prumet(s)
will be made by me or the t taintenance and repair made by my regular Roof drain(commarcr )
employee on the property 11wn as per ORS Chapter 417. Sink(s),basin(s), ays(s) —
Ownef's sl anus: Date: sump - — --�-_--
` Tubs/shower/shower pan
lhinal _
Name: -_ _ _-----_- itwl t luset
Address,. -
—...__ atcr heater
Ci — 1 State. IP Other;
Phone: Tax. I-` mail! oral
— -- ---- Mlnimurr fee................S
Na W lwlWkUow wap crwil cards jdeaw tali junl,ictloa for mon tnfr ioe. Notice:Phis permit application — - -
)kMba U Mart*K'W yu L'/t expires ire permit is not obtained Plan review(at _. 'si) $ ---- ---
Gt t c State surcharge(8%). ..$
rwdl, r+iter: L_— with: 180 days after it has been
j'1i0 _� , ex/Ms accer•ted as complete. TOTAL ................... ...$
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CITY OF TIGARD
13125 S.W. FALL 3LVD.
TIGARD, OR 97223 Q
IMPORTANT PERMIT NOTICE
s
FRANKLIN ELECTRIC INC
28.$9-SE-4-8T-H-CtRCL�E rj Cf—
GRESHAM,
OR 97080
fo �I
Electrical Signature Form RECEIVED
Permit #: MST2002-00235
I(in�
Date Issued: 615102 ' !12
Parcel: 2S109AA-05700 CI11'UFY�I
Site Address 14330 SW 128TH PL ( '/ �NNIIV GARD
Subdivision: ELK HORN RIDGE ESTATES G/ENGINEER(Nf3
Block: Lot: 023
Jurisdiction: TIG
Zoning: R-7
Remarks: New SF detached, Path 1.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed forrn is received
OWNER. ELECTRICAL CONTRACTOR:
PAUL CARNEY INC FRANKLIN ELECTRIC INC
1480 NW 102ND AVE 2889 SE 18TH CIRCLE
PORI LAND, OR 97224 GRESHAM, OR 97080
Phone- #: 503-297-9406 Phone #: 492-4651
Req #: LIC 140170
ELE 26 'uvi:
SUP 2260S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
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Signatureofto ;rvising Electrician
If you hove any questions, please call (503) 639-4171, ext. # 310
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CITY OF TIGARD
1312'�,,S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE p '
L.if
MALMEDAL PLUMBING INC
111 S 18TH AVE 1UN 1 o 2007
CORNELIUS, OR 97113 ,x; Y U"
Plumbing Signature Form
Permit #: MST2002-00235
Date Issued: 6/5/02
Parcel: 2S109AA-05700 l ��y
Site Address: 143315 SW 128TH PL
Subdivision: ELK HORN RIDGE ESTATES
Block- Lot: 023
Jurisdiction: TIG
Zoning: R-7
Remarks: New SF detached, Path 1.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign beiow and P'-wrn
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized 1-ntil this completed form is received
OWNER: PLUMBING CONTRACTOR:
PAUL CARNEY INC MALMEDAL PLUMBING INC
1480 NW 102ND AVE 111 S 18TH AVE
PORTLAND, ORM 97224 CORNELIUS, OR 97l1
Phone #: 503-297-9406 Phone #: 503-310-91-95
Reg #: I IC 102535
PI M 34-276PB
AN INK SIGNATURE iS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If you hav- any questions, please call (503) 639.4171, ext. # 310