13520 SW 129TH AVENUE s:1
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Page No. 1 CASE HISTORY FOR CASE NO.: M.4T97-0238
DOUG ZIEBART CONSTRUCTION
13520 SW 129TH AVG
03/02/98 '
Req/ Schd/ End/ Action Notes
Diap By Update Upd
Action Description Date By
code Sent Done Done
DEB 06/18/97 RDP
MSTA005 Apple,-ti.an received / / / 05/22/97
05/22/97 DEH 06/18/97 ?,DP
Permit Created / / / / 06/18/97 JDA
MSTA0.10 check for prcl. restrict. / / / 06/18/97 ,IDA 06/18/97 RDP
MSTA012 plans routed to Plans Examiner / / / / 06/05/97
06/18/97 APPR RDP 06/18/97 RDP
MSTA030 Reviewed plane rouLed to DSTS / / / / PASS B 06/20/97 BON
MSTA032 DST Post_*A, jew 7ompleted / / / / 06/20/97
MSTA050 Hold for 11/12/97 HOLD FINAL INSPECTION UNTIL USA HAS HOLD HAP 11/12/9'1 DOW
APPROVED FINAL, EROSION
C•ONTROI.... ..... . ... .HAP
MSTA050 Hold for 12/31/97 building final approved, but no 32/31/97 JT
electrical signature form. 12/31/97
mailed another one to contractor. hold
c/o until returned. Jeanne t.
MSTA055 Hold Release 11/20/97 Releane hole for erosion control. RELS HAP LI/20/97 DOW
Phonecon from chuck Buckallew today
saying final erosion approved.
MSTA080 SF) Ready to issue / / 06/20/97 need copy of supervisors licenae from MEMO 11 06/20/97 BON
the electrician
PASS URA 06/23/97 DST
i:1TA09). (F) Issue combination permit / / / 06/23/97 REcD SW 07/01/97 S'W
M.STA095 issue plumbing signature form / / / / 07/01/97
06/23/97 PASS DRA 06/23/97 DDT
MSTA097 Issue electric signature form / / / / RECD JMT• 01/20/99 JT
MSTA097 Issue electric signature form / / / / 01/20/98
/ / 06/19/97 JDA
MS"-'A700 Erosion C0nt01 / / / /
MSTA700 Erosion Control 7anp 844-9444 / / / / 11/20/97 Phoneccar w/Chuck rA USA....final. erosion FABS HAP 11/20/97 DGW
control Comp]e':s
06/25/97 PASS RS 06/29/97 J-H
M.4TA705 Footing Inap 06/31j/97 JDA
MSTA706 Foundation Insp
MSTA707 Slab Inap 09/04;97 Jointed r,lah: Provide protective barrier PASS RS 09/07/97 J•H
CL at from' of mechanical equipment..
Prote,.t metal 6 mechanics! from
concrete.
� 06/18/97 JDA
J MSTA710 Poet/Beam Structural / / / / /
06/19/97 JDA
_p MSTA711 Poet/Beam Mechanical / / / / / / 06/19/97 ,IDA
r' MSTA713 Crawl. Drain / / / / / / PASS MS 08/18/97 MRS
WM,4 / 08/15/97
J TA717 P[i4/t�,:•+erfloor 08/15/97 PASS MS 09/19/97 MRS
MSTA720 Mechanical Znnp 5/97 PASS MS 09/18/97 MRS
MSTA722 Plumb Top Out 09/7
/ / PASS BRP 09/19 97 B°P
MSTA723 Electrical Service / /
08/15/97 Provide a recept-.cle at .ear in
accordance w'.Ln article, 250-52
(s).Verify at final inspection.
page No. 2 CASE HISTORY FOR CASE NO.: MST97-0238
DOUG 2•IEBART CONSTRUCTION
13520 SW 129TH AVE
03/02/98
Action Description req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA724 Electrical Rough In / / / / 09/15/97 PASS BRP 08!19/97 B-P
MSTA725 Framing Inep / / / / 08/18/97 #-1- positive connection 6/6 poet to DIS KS 08/19/97 KBS
glu/lam at garage
#-2- support under double hip at garage
# 3- nail rafters at ledger. garage
#-4- positive connection paralam at
garage
#-5- strap each side of plates notched
for mechanical
#-6- provide full bearing under paralam
supporting partial roof / ceiling
load
#-7- vapor barrier not installed at
crawl space
#-8- eave baffles not installed
MSTA725 Framing Inep / / / / 08/20/97 #-1- ntrap each side of notched platee DIS KS 08/20/97 KDS
at lower level
at waste and mechanical heat duct
#-2- fireplace not installed at lower
level
#-3- extend eave baffles at vaulted
ceiling above
insulation line at flat
#-4- insulate heat lucto at lower level-
basemfmt to
R-B- value also rim joist unfinished
banement
MSTA725 Framing I:.sp / / / / 08/21/9' #-1- exterior deck not complete at thin A/N KS 09/22/97 KBS
time
M.STA726 Shear Wall Inep / / / / 08/18/97 1. Appraved as noted; install plywood PASS KS 08/18/97 J•11
interior side of garage wing walls an
p- ahovu will recheck at framing
�� in spect i m.
H
> MSTA727 Low Voltage / / / / 11/1.3/97 PASS MJR 11/13/97 MJR
r
M9TA735 Gas Line Inep / / / / Oe/15/97 PASS MS 08!18/97 MRS
M3TA740 Insulatirm Inep / / / / 08/21/97 #-1- basement unfinished at this time. A/N K9 0e/22/97 KBS
contractor will coved exposed
W insulation with FS paper if i if upon
J
sale remains unfinieh.
Cage No. 3 CASE HISTORY FOR CASE NO. : MST97-0238
DOUG ZIEBART CONSTRUCTION
13520 SW 129TH AV13
03/02/9^
tion Description Req/ Schd/ End/ Action Notes Dinp By Update Upd
t As Sent Done Done Date 'y
MSTA745 Gyp Board Inep / / / / 08/26/97 Drywall nail-'ng not approved: FAIL KS 08/28/97 J-H
1. Maintain one clearance at b-vent
garage ceiling.
2. Apply gypsum behind stairs at garage.
3. Remove vapor barrimr at water proof
gypsum.
4. Provide approved plann on site to
verify if shear vall nailing in
applicable at gypsum.
MSTA7i5 Gyp Board Inep / / / / 08/27/97 1. s,ipport b-vent to maintain ons-ince PASS KS 08/27/97 J-H
clearance at b-vent.
2. shear nailing not applicable at
gypsum.
3. Lower level unfinished at thin time
if not finished (exposed insulation)
will RE: FS paper covering.
MSTA755 Rain drain Inep / / / / 06/30/97 1. Need to go out 4" PART MS 07/08/97 J-H
2. Around house ok
3. Requires back-water valve or perf
pipe
MSTA755 Rain drain Inep / / / / 09/18/97 Trench drains behind house. PASS RAR 09/18/97 RAB
MSTA760 Water Line Tnsp / / / / 06/33/97 PASS MS 12/16/97 8•W
MSTA765 Appr/Sdwlk Inep / / / / 09/05/97 OE to pair (talker! w/contractor) . PASS MH 09/11/97 S•W
MSTA790 Electrical Final / / 7 / 11/13/97 PASS MJR 11/13/97 MJR
MSTA790 Electrical Final / / / / 12/15/97 Previous approval by MJR on 111397. NOTE BRP 12/15/97 J•H
MSTA795 Mechanical Final / / / / 12/19/97 #-1- nee bldg final thin date DIS RS 12/19/97 KBS
MSTA795 Mechanical Final / / / / 12/29/97 PREVIOUS CORRECTIONS FROM 121897 PASS GS 12/29/97 J•H
C•- APPROVED
N MSTA797 Plumb Final / / / / 12/15/97 Unable to inspect - not water to test FAIL MS 12/15/97 J•H
r fixtures.
J
MSTA797 Plumb Final / / / / 12/16/97 PASS MS 12/19/97 J*H
L7
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'Page No. 4 CASE HIS'T'ORY FOR CASE NO.: MST97-0238
DOUG T.IEBART CONSTRUCTION
13520 SW 129TH AVE
03/02/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent L m 9 Done Date By
MSTA799 Building Final / / / / 12/19/97 #-1- cover entire c--awl space ( vapor UIS BS 12/19/97 BBS
barrier)
#-2- remove wood / debris crawl
4-3- provide drainage at interior ftge
to low point drain
#-4- provide guardrail at open side of
stairs lower level.
#-5- insulate exposed wye's at heat
ducts
#-6- remove dirt from fdn vents and
slope finish grade away from
atructure.
#-7- support gas piping at watwe heater
MSTA799 Building Final 12/29/97 / / 12/29;97 Previous corrections dated 121897 pass PASS GS 12/29/97 J•H
MSTA960 (F) Issue Cert, of Occupam-y / / , ! 12/29/97 mailed 3-2-98 03/02/98 S+W
F-
F-
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Page No. 1 CASE HISTORY FOR CASE NO.: SWR97-0227
DOUG ZIEBART CONSTRUCTION
13520 SW 129TH AVE
03/02/98
Action Description Reg/ Schd/ [did/ Action Notes Disp By Update Upd
code Sant Dame Dame Date By
1
SWRA003 Application received / / / / 06/18/97 PASS JDA 06/18/97 JDA
SWRA008 Permit Created / / / / 06/19/97 PAS JDA 06/18/97 JDA
SWRA080 (F) Issue permit / / / / 06/23/97 PASS DRA 06/23/97 DST
SWRA705 So-war Inspection / / / / 06/30/97 PASS MS 12/16/97 S•W
SWRA720 case Finaled / / / / 12/16/97 12/16/97 JT
CL
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CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
CERTIFICATE' OF
OCCUPANCY
I PERMIT *. . . . . . . • IYIST97-IV38
I DATE ISSUED: 12/2-9/1)7
PARCEL-. 2 S 104DD--09300
3I TE ADDRESS. . . i 13'�;?0 SW 129TH AVE
SUBDIVISION. . . . : MOUNTAIN 1.41GHLANDS NCI. :' 7LIN ING:R-•4. 5
BLOC:K. . . . . . . . . . . LOT. . . . . . . . . . . . . :1351 .JURISDIC:TION:TIG
CLASS OF WORK. :NCW
TYPE OF U9E-. . . :SF
TYPE OF CONSTR:5N
OCCUPANCY GRP. r Etas
OCCUPANCY LOAD c 2
Remarks : Rath 1
Owners
DOUG ZIEEBART CONSTRUCTION
PO PDX 80402
PORTLAND OR 97280
F'fh o n e 'li: 245--5433
C.Eontrar_tor:
DOUG Z IE PART CONSTRUCTION INC
PIJ BOX 0!J402
PORTLAND OR 97230
Phone ;in
Reg 000964
Thts Certificate grants OCCupancy of the above refervitried building or, portion
thereof and confirms that the b+_tildiny ham been inepi!r_ted for,, compliance with
!:he State of Oregon Specialty Codes fnr the group, jCC1.tp2nc*, anci Lio-.e under,
which the roferenr.eci permit was issuerl.
i– PI.J1I._DING IIVC' ECMR — E►UI4Dt�, �F TCIAL
-� {=COST IN CONSPICUOUS PLACE
� I
_J
A CITY OF TIGARD MASTER PERIrIIT
DEVELOPMENT SERVICES F,ERMIT #. . . . . . . : MST97-0 '38
DAT_- ISSUED: 06/23/97
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
PARCEL: E:S 104DD-09300
SITE ADDRESS. . . : 13320 SW 129TH AVE
SUBDIVISION. . . . :MOUNTAIN HIGHLANDS NO." ZONING: R--4. 5
BI_L7'�K. . . . . . . . . . LOT. . . . . . . . . . . . . :051 JURISDICTION:
Remarks: Path I
--------------------------------------------------------------- BUILDING ------ -------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- 3ASEMENT...: 921 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.-.NEW HEIGHT........: 29 FIRST....: 1218 ,f GARAGE.....: 704 s' LEFT..........; 5 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 50 SECOND...: 1183 sf FRONT.........: 20 PARKING SPACES: 2
TYPE OF CONST.:SN DWELLING UNITS: i FINDSMENT: 0 sf RIGHT........... 5
OCCUPANCY GRP.:R3 BORN: 4 BA 1H: 3 TOTAL----: 2401 sf VALUE..1: 184844 REAR..........: 20
-------------------•-------------------------------------------- PLUMBING ----------------------------- --
SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..; I LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 100 TRAPS.........; 0
LAVATORIES....: 5 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 2 GARBWT D1SP..: I WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------------------------------------------------------------------ 1ECHANICAL --------------------
FUEL TYPES----------- FURN ( 1Ofl( ..: 1 BOIL/CMP ( 3HP: 0 VENT FANS...... 3 CLOTHES DRYERS: 1
GAS FURNf=I W, ..: 0 UNIT MATERS..: 0 HOODS.........: 6 OTHER UNITS...: 1
MAX INP.: 200000 BTU FLOOR FURNACES: 0 VENTS.,.......; 1 WOODSTOVES....: 0 GAS OUTLETS...: 1
------------------—--------------------------------------------- ELECTRICAL ------------------------------------------------------------ -----
—RESIDENTIAL UNIT--- --SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS---
1000 SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FOR. : 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5O0SF.; 6 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/0 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER DOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIA: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MWIF HM!SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: P MINOR LABEL -10: 0
100@+ :Iplvolt.: 0 -----------------------•----------- PLAN REVIEW SECTION ----------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: 1 600 V NOMINAL: CLS AREA/SPC OCC:
-------------------------------------------------- ELECTRICAL •- RESTRICTED ENERGY ------•-------
A. SF RESIDENTIAL---------------------------- B. COMMERCIAL----------------- - -----------------------------------------------
AUDIO I STERES.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BUPGLAR ALARM..: OTH: :; BOILER.........: HVAC...........: I-ANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGL OPENER..: X CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURGE CALLS....: TOTAL # SYSTEMS: 0
Owner: - --- ----- --------------------Contractor: -----------------------------• TOTAL FEES:$ 4865.36
DOUG 2IEBART CONSTRUCT L9N DOUG ZIEBART CONSTRUCTION INC This permit is subject to the regulations contained in the
PO BOY 80402 PO BOX 80402 Tigard Municipal Code, State of Ori. Specialty Codes and all
PORTLAND OR 97280 PORTLAND OR 97230 other applicable laws. All work w,ll be done in accordance
with approved plans. This permit will expire if work :s
Phune M: 245-5433 Phone N: not started within 180 days of issuance, or if the work is
Reg C.: 000%4 suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted h the Oregon Utility
Notification Center. Those rules are set forth in OA? 952-001-0010 through OAR 952-001-0080. Yaq may obtain copies of these rules or
direct questions to OUNC by calling 1503?246--1987.
_ -----------------------•----------------------------------- REQUIRED iNSPECTIOW. ----------------------------------------------------- --
Erosion Contol Post/Beam Mechan Electrical Serv: Gds Line Insp Water Line Insp Plumb Final
Grading Insperti Crawl Crain Electrical Rough Gas fireplace Water Service In Building Final
Footing Insp PLM/Underfloor Framing Insp Insulation Insp Appr/Sdwlk Insp
' Foundation Insp Mechanical Insp Shear Wi In n Gyp Board Insp �I ctrical Final
Post/Beal Strur,-- Plumb Top Out Low Voltage Rain drain Insp M I nical final
Issi.ied y : , c�� 2
�� U Permittee 5ignat�.rree'�
++++ +++++++}+i ++++++++++++i++++t4+++++• +}+++ ++• +++++ ++"+-++t++++
Call G39-41.75 by 6:00 p. m. for- an inspection needed tFre next bi.i iness day
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : SWR 97-0 :7
DATE ISSUED: OF/; 3/9'7
PARCEL: 2S 104 DD-09300
SITE ADDRESS. . . : 1:35Z_0 SW 19TH AVE
SUBDIVISION. . . . :MOUNTAIN HIGHLANDS NO. 3 ZONING: R-4. 5
BLOCK. . . . . . . . . . LOl.. . . . . . . . . . . . . :051 JURISDICTION:
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 16
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . — .SF NO. OF BUILDINGS: 1.
INSTALL TYPE. . . . :BUSWR IMPERV SURF=ACE : 0 sf
Remarks : Fath I
Owner _-___.___.._.._.--•---- ------------_._._-----.____.__ FEES _._------•---__.____
DOUG ZIEBAPT CONSTRUCTION type amoi.rnt by date recpt
PO BOX 80402 F'RMT E 2200. 00 DRA 06/c'-:.'3/97 97-296300
PORTLAND OR 97280 INSP $ :5. 00 DRA 06/27z/97 97-296300
Phone #:
Cantrartor: •-_•-----__---.-_.-__-------------_
OWNER
Phone #: S 2235. 00 TOTAL
Req #. . -.
- ----- REQUIRED INSPECTIONS ------ -
This
--_--- -This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewane Agency. The permit expires IN days from -
the date issued. The total amount paid will be forfeited if the
perm,t expires. The Agency does not guarantee the accuracy of rhe
side s,,4e,- ',erals. If the seer is not located at the measurement
given, the installer shall prospect 3 feet in all directior,; from
the distance gi•,,en. If not so located, the installer shall purchase
a "Tap and Side Sewer" 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 952-0081-0080. You may sbtain copies of _ W
these rules or direct questions to DUN[ by calling (503)246-1987.
I s s i-red h �rl .( �OCt �'l�Ll�) _ Permittee S i g n a t u r,b,:
++++-H++++++++++4++++++++++++++++++-F++++++i-+++++++++++•t++++++++++++ +++++++++-F++ 1-
Call 639-4175 by 6:00 p. m. for an inspection needed the next bi_isiness day
++++++++++++++++++++++,-+++++++++++4•+4+++++++++++++++++++4++++++++++++++++++++++-�
Plan Checks
TIGARD Residential Building Permit Application Recd By (i_ - ��
5 SW HALL BLVD. New Constructic^ Additions or Alterations Oate Recd �
IGARD, OR 97223 Single Family Detacned or Attached (Duplex) Date to P E
503-639-4171 Date to DST �y,7
$03-6134-7297 rrlur ►^ �(, , Permit*�
Print of- Type T?) G�� n Called ) '
Incomplete or illegible applications will not be acc pted
Name of Proles Name
Job l ��° } l' ; ''�J cvPc.''7ttr�5
Address Site Address Arch'tect Mailing Address
_,c> u� /2-0
Namejj Gry/State Zip Phone
L'
t" CM S• ,>'>C—_
Owner ailing Address Name
(�
' _ C, t 1A 't - ;\ i?v -0_J e ( I
Cipistate Zip Phone Engineer mailing Address
ddress
0L4v _. 1 z. '--43it
Name CiryiState Zip Phone
_ -7
General �.,���, De=iba work New Addition O Atteration O Repair 0
Contractor Mailing Address to be done
Additional Description of Work:
cirylstate Zip Phone
Oregon Const.Cont. Bov;d Lic+* E_.pDa te
ttach Copy of i C 4
Current COT Business Tax or Metro r Exp.Date PROJECT
Licenses _ - f VALUATION
Name --
Mechanical ri t. P �-�.> . NEW CONSTRUCTION ONLY:
Sub- Mailing Addresb Sq. FL House: Sq. FL Garage
Contractor
Comer Lot YES NO Flag Lot YES NCi
G,ryrState zip Phone (check one) (check one) _
Oregon Const.Cont Board Licit Exp.Date Restricted Audio/Stereo Barglar
tach Copy of UCJ y `r,=Z,`'1-ti Energy System _ Alarm
Current COT Business Tax or Metro it Exp.Date Installation Garage (Door HVAC
Licenses / /-Q`? \/i Opener Systems
Name
'lumbin (Check 411 that Other.
Q t'i hr _ apply)
Sub- Mallillig Address Will the electrical subcontractor wire for all `(�S NO
,ontractor restricted energy installations?
77_-ry_'State Zip Phons Has the Subdivision Plat recorded? 'WA YES NO
Oregon Const. Cont. Board Lic.M Exp pate Reissue of MST#: Solar Compliance
r
ach Copy of y, 2 , C(-
Current Plumbing Lic.>: Exp,pate _ (Calculation Attache J)
Licensesr I t- To -I >earby acknowledge that I have read this application, that the
information given is correct. that I am the owner or authorized
t COT Bus ss Tax or Metro# Exp. Date
/ b �� _(_ agent of thR owner, and that plans submitted are in compliance
Name —" with Oregon State la s.
'- :t i ectrical Signature of ner/ gent Date
Sub_ Mailing Address C S
L
ontact Person N• e' Phone#
Contractor
'j C.tyiS:ate -tip I Phone FOR OFFICE USE ONLY:
_I
_ _ Plat#: MaplTL#:
Oregon Const. Cont. Board Lic x Exo Date "� .7 it, !. �+D � 1-300
mach Cony of 10
C 7 a - f 4 Setbacks: I 4ane: Solar.
Current E!emcal Lic,0 Exp.Date
Licenses 7 ._ ?(_r. C _ /(? / -4 1 Engineering Approval: Planning Approval: TIF
CCT Bismess Tax or Metrc t Exp Date I tl
L t t �' is fapp.Qoc tdst) 1/97
err, ,Ltd Lc o int P!= ion
Am.Q.= Amt.Pd. Bal, Due
33
(BUILD)
T. Permit BUILD -� _—•- -
�.. (PLUMB)Plumb. Permit
���' �`� j ✓
Mech. Permit
�b
ELC/ELR Permit (ELPRMT)
State Tax
(TAX)
Bldg:
Plumb:
Mech:
ELC/ELR: 2
Plan Check
6'9
MST: (BUPPLN) --
Plumb: (PLMPLN)
Mech: (MECPLN) _ - ;7 - --zy
A (LANDUS)
CDC Review
_1 ��'2dD -Zo o
7Li1r��17�-Viewer Connection (SVVU SA)
)
Reimbursement District ( --
Sewer Inspection (SWINSP) ✓
Parks Dev Charge
Residential , IF
(TIF-R) i '' 7� - _ /,5 ?V
MT
IF- )
Mass Transit TIF (T -'
Water Quality
LL
(11VQUANT)
Water Quantity
Erosion �.ontrol Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) -
gd
gv
EROSN)
Er,.,�ion ?lanck/COT ( -
Fire Life Safety (FLS) _ - -
n `' D 7-
ll O ✓ o �dsq 1197
TOTALS:
i.wapp d
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L 3Z EL 32S
1
S �iF Penia - seo:en
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51
M ov-n�u�-. ►4-,��lana ss 3 rn o�e�4�. ,°
104 DD
K 3 5 Gc.l�cr DSS A+r:c�+�.•i- '.-r��c:•�
l I
I
I T I J
M Lo� size- /3, 003 v
s /4 ouw- Size- i IF y3'
E Comedy S,it 660 �jj j o
iO I jzt Jno Gvtr t / `f 0,
u) BaS-I "nr.ON-- Lt 316 O
I � v
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i g v\
uwsc �L 3S '•
(
C§!
7
G-^Aye i e4 3s6 I 1
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Sit i
�� 35 0 �� ! 3510 Sw lzq}^ Fve �,.
CITY OF TIGARD
13125 S.W. HALL BLVC.
TIGARD, Ori 97223
111APORTANT PERMIT NOTICE
A C I MECHANICAL
12300 SW 69TH
TIGARD OR 97223
Plumbing Signature Form
Permit # . . . . : MST97-0238
Date Issued. : 06/23;97
Parcel . . . . . . : 2S104DD-09300
Site Address : 13520 SW 129TH AVE
Subdivision. : MOUNTAIN HIGHLANDS NO.3
Block. . . . . . . . Lof- : 051
Zoning. . . . . . . R-4 . 5
Remarks :
Path I
Your company has been indicated as the plumbing contractor for the rerroit indicated above. In order
for the plumbing permit to be valid, please have the appropriate individual from your cor,jpany sign
below and return this Plumbing Signature Form prior 'r, the start of work. NO plumbing inspections
will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: PLUMBING CONTRACTOR:
DOUG ZIEBART CONSTRUCTION A C I MECHANICAL
PO BOX 80402 12300 SW 69TH
PORTLAND OR 97280 TIGARD OR 97223
Phone # : 245-5433 Phone # :
Reg # . . : 000006
S nature of Authorized Plumber
I
Please return this completed form to the address above.
ATTN: 3uilding Dept.
If you have any questions, please call 639-417 1 , ext. #310
i
c,%
CITY OF TIGARD
I
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERIMI , NOTICE
XL ELECTRIC
581 LANCASTER DRIVE S.E.
SUITE #50
SALEM OR 97301
Electrical Signature Form
Permit 4 . . . . : MST97-0238
Date Issued. : 12/31/97
Parcel . . . . . . : 2S104DD-09300
Site Address : 13520 SW 129TH AVE
Subdivision. : MOUNTAIN HIGHLANDS NO. 3
Block. . . . . . . . Lot : 051
Jurisdiction: TIC
Zoning . . . . . . . R-4 . 3
Remarks :
Path I
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 c-mpany sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REOUIRED ON THIS FORM
OWNER : ELECTRICAL CONTRACTOR:
DOUG ZIEBART CONSTRUCTION XL ELECTRIC
PO BOX 80402 581 LANCASTER DRIVE S.S.
PORTLAND OR )7280 SUITE #50
SALEM OR 97301
Phone # . Phone # : E503-391-6705
Reg V . : 001.094
x �•�c�^
Si natureo Sf upervising Electrician
Please return this completed form to the address above.
ATTN: )uilding Dept. �4Yl
If you have an t questions, rlease call 639-417 1 , ext. #310
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