13958 SW HILLSHIRE DRIVE k'
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__ '.%458 SW HILLSHIRE DRIVE _
CITY OF TIGARD
DEVELOPMENT SERVICES
MW
10"125.4W Hall Blvd., Tigard,OR 97223(503)639-4171
CERTIFICATE OF
OCCUPANLY
PERMIT #. . . . . . . : MST96-011.1
DATE ISSUED: 11/01/96
PARCEL: RS104CC-03600
SI'l E ADDRESS. . . : 13958 SW HILLSHIRE DR
SUBDIVISION. . . . : HILLSHIRE ESTATES NO. 2 ZONINGtR-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 142 JURISDICTION:1'16
-----------------------------------
LLASS OF WORK. :NEW
'FYPE OF USE. . . :SF
I-YPE OF CONS*IR:SIV
OCCUPANCY GRP. :R3
OCCUPANCY LOAD:i?
RemAt-ks : PATH I
Owner:
DAVID FARBER
13958 SW HILLSHIRE DRIVE
TIGARD OR
Phone #-
Uontr,ectov-i
WINDWOOD HOMES
12655 SW NORTH DAKOTA
(F(4x # 590-7606)
TIPORD OR 97223
F-'hon. t?)0-4700
Reg #. . : 000501
Fhic Let-tificate gr-ants occupancy of the above referenced building Or, po 1. 1Crj
thereof and confirms that the building lias been inspected for compliance wj + 1,
the State of Oregon Specialty Codes for, the group, occupancy, and use under-
which the t-efer-enced permit was issued.
6XL.
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,WLDlNi7 16"Jl--'LLTUR BWJ-Ino "M MF�Olel / lN934PE--CTUP
1JN, LH)ic;UH
POST IN CONSPICUOUS PLACE
Page No. 1 CASE HISTORY FOR CASE NO.: MST96-0113
WINDWOOD HOMES INC
13958 SW hILLSHIRE DR
03/12/99
Action Description Req/ Schd/ and/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA005 Application received / / / / 03/11/96 PASS JD 03/7.1/96 BT2
MSTA008 Permit Created / / / / 03/21/96 PASS RT 03/21/96 BT2
MSTA010 Check for prcl. restrict. / / / / 03/;:1/96 PASS JD 03/21/96 BT2
MSTA012 Plans routed to Plans Examiner / / / / 03/21/96 PASS JD 03/21/96 BT2
MSTA02F ::ane approved by Plans Exmr / / / / 03/21/96 PASS RT 03/21/96 BT2
MSTA030 Reviewed plans routed to DSTS / / / / 0?/21/96 PASS RT 03, v6 BT2
MSTA080 (F) Ready to issue / / / / 03/71/96 PASS CJS 03/22/96 TMP I�
MSTA092 (F) Issue combination permit / / / / 03/26/96 PASS 0 03/26/96 BON
MSTA093 (F) Reprint Permit / / / 01/27/97 Sent 3rd copy to be signed. KAS 01/27/97 KAS
MSTA097 Issue plumbing signature form / / / / 03/26/96 PASS B 03/26/96 BON
MSTA097 Ise.ue plumbing signature form / / / / 11/14/96 11/14/95 JT
MSTA097 Issue electric signature form / / / / 01/31/9! Recd sign form back 1/30/9, PASS KAS 01/31./97 JT
MSTAU98 Issue electric signature form / / / / 03/26/96 PASS B Oe;26/96 BON
MSTA705 Footing Insp / / / / 04/12/96 0 1- extend retaining wall section at DIS KS 04/15/96 KBS
rear of garage
MSTA705 F(oting Insp / / / / 04/15/96 APP KS 04/16/96 K13S
MSTA706 Foundation Insp / / / / 04/18/96 pending- seismic; ventilation; clear low PASS RB 04/18/96 RB
point drain; usa 4-19
MSTA710 Poet/Beam Structural 05/17/96 / / 05/17/96 glu-lam beams notched- engineering FAIL RB 05/17/96 HE,
req'd; aadit icnal nails req'd w/in
brackets; positive connections- marked;
head of over plenum box; additional gyp.
nailers needed at garage/shed header;
lateral brace posting
MSTA711 Post/Beam Mechanic.l (;/17/96 / 05/17/96 PASS RB 05/17/96 RB
MgTA713 Crawl Drain / / / / 04/30/96 PASS MS 15/01/96 MRS
M'3TA.^,1° P1,M/Underfloor / / / / 05/15/96 PASS MS 05/16/96 MRS
MOTA720 Mechanical InsE / / / / 07/30/96 1-1" min. clearance at vent and garage FAIL rib 07/31/96 BT2
soffet
2-underfloor ducts not installed to
floor bvot(2)
3-supply to run above garage not
connected
inpection terminated
Page No, 2 CASE HISTORY FOR CASE NO.; MST96.0113
WINDWOOD HOMES INC
11958 SW HILLSHIRE DR
03/12/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Up'l
Code Sent Done Done Date B,
MSTA720 Mechanical Insp 08/12/96 / / 08/12/96 remove cable away from b-vent; exhaust FAIL RS 08/12/96 RS
venting incomplete; secure fireplaces;
insulate . flame spraed fitcplace
cavities; maintain installation
instructions for clearances and venting
for fireplaces; enclose floor cavities
w/inchase at main floor maintain b vent.
clearances at chase upstairs; exhaust
vent disconnect at laundry.
MSTA120 Mechanical Inep CB/15/96 / / 08/15/96 see framing this date FAIL RB 08/15/96 RS
i
MSTA720 Mechanical Insp / / / / 09/09/96 A9P KS 09/11/96 RB {
MSTA122 Plumb Top Out / / / / 07/09/96 waste ok FAII. MS 07/10/96 MRS s
no test on water
MSTA722 Plumb Top Out 07/11/96 / / 07/11/96 PASS Ned 07/25/96 ST2
MSTA123 Electrical Service / / / / 07/26/96 PASS MJR 07/26/96 MJR
MSTA725 Framing Insp 08/15/96 / / 08/15/96 mech incomplete- 8-12 report FAIL RS 08/15/96 RR
shear req'd to be approved.
i
MSTA725 Framing Insp / / / / 09/06/96 M 1- nail tji hangers at garage DIS KS 09/09/96 KSr
#-2- provide full bearing post
supporting r000f load adjacent to
stair la*ling
M-3- additional nailing needed at stair
landing to studs
N-4- provide double hanger at double tji
0-5 support hips, valleys, and ridge,
double 2/4 struts
!
greater then six ft in length {
MSTA725 Framing Insp / / / / 09/09/96 APP KS 09/10/96 KBS
MSTA726 She-ir Wall Insp 07/16/96 / / 07/16/96 no plans on site FAII. RS 08/05/96 R.B
MSTA726 Shear Wall Insp 08/05/96 / / 08/05/96 no plane! FAIL RB 08/05/96 RB
MSTA126 Shear Wall Insp 08/21/96 / / 08/21/96 nail splices; hd's missed! FAIL RB 08/22/96 RB j
MSTA726 Shear Wall Insp / / / / 08/26/96 p-1 no plans on site DIS KS 08/27/96 KBS j
MSTA726 Shear Wall Insp / / / / 09/05/96 M 1 nailing app at shear panels PART KS 09/06/96 KBS
N-2 install washers at HD20 K holdowns
also at HTP
t
Page No. 3 CASE HISTORY FOR CASE NO.: MST96-0113
WINDWOOD HOMES INC
13958 SW HILLSI'.I7E DR
03/12/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA726 Shear Wall Insp / / / / 04/05/96 #-1- nail T•1i joist hangers at garage DIS KS 09/06/96 KBS
#-2- fill baring under post adjacent to
entry
k -e- additional nailing at stain landing
#-4- 'drovide hangers at double jo.st
k-5- support hips, valleys, ridgr ac
shovn also double
20 struts if six ft length
MSTA726 Shear Wall Insp / / / / 09/09/95 APP KS 09/10/96 KBS
MSTA727 Low Voltage / / / / 08/12/96 complete log DIS MJR 08/13/96 MJR
staple conductors
MSTA727 Low Voltfge / / / / 09/16/96 PASS TLP 10/09/96 TLP
MSTA735 Gas Line Insp 08/12/96 / / 08/12/96 PASS RB 08/12/96 RS
MSTA735 Gas Line Insp / / / / 09/27/96 PASS RP 09/27/96 RB
MSTA740 Irsulatior, Insp / ! / / / / 03/21/96 BT2
MSTA740 Insulation Iisp / / / / 09/11/96 pending remove insulation away from PASS RB 09/12/96 RB
B-vent at garage; insulate vaulted
spaces above LR/Fuver; Insulate arc
window at upper stairs; firestop thru
peneL•ratiuns; insulate hard to reach
areae; low volt. failed]
MSTA745 Gyp Board Insp / / / / 09/13/96 APP KS 09/13!96 KBS
MSTA755 Rain drain Insp / / / / 04/30/96 PASS MS 05/01/96 MRs
MSTA760 Water Line I p / / / / 04/30/96 PASS ME 05/01/96 MRS
MSTA765 Appr/9dwlk Insp / / / / 02/26/97 Final. PASS PI 02/26/97 KAS
MSTA790 Electrical Final / / / / 10/31/96 outside fixtures not tight to wall PASS MJR 11/01/96 MJR
Master bath fixture not listed for
ceiling
MSTA795 Mechanical Final / / / / 10/31/96 APP GS 11/01/96 GES
MSTA797 Plumb Final / / / / 10/30/96 pouring concrete NR MS 10/31!96 MRS
no address
MSTA797 Plumb Final / / / / 10/31/96 no water to lav FAIL MS 11/01/96 MRS
shut off valve not accessible
MSTA797 Plumb Final / / / / 11/01/96 torr by me ok APF G8 13/01/96 GES
MSTA799 Building Final / / / / 10/31/96 DIS GS 11/01/96 GES
MSTA799 Building Final / / / / 11/01/96 APP GS 11/01/96 GES
MSTA960 (F) Issue Cert. of Occupancy / / / / 11/01/96 03/12/99 JT
MSTB708 Erosion Control / / / / / / 03/21/96 BT2
Page No. 4 CASE HISTORY FOR CASE NO.: MST96-0113
WINDWOOD HOMES INC
13958 SW HILLSHIRE DR
03/12/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
CITY OF TIGARD BUILDING INSPECTION DIVISION M C��A ,•,ll
24-Hour Irspection Line: 639-4175 Business Line: 639-4171 ST
—
BUP -
_ Date Requested AM —PM BLD
Location A3� // Suite MEC
Contact Person _ Ph _S-�_[/ /�4� _ PLM
i
Contractor _ L Ph -7 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Acc ---
Foundation NOT REQUESTED FPS
Fig Drain FOUND DURING RESEARCH SGN
Slab Crawl Drain InsF NO INSPECTION(S) FOUND IN FILE
Post& Beam - SiT u—
Ex Sheath/Shear
Int .'heath/Shear
Fram ng ---- — — -
Drywall Nailing
Firewall ,
Fire Sprinkler ,t
Fire Alarm
Susp'd Ceiling �GC.2 '`�31----
Roof
Misc: - ----- ----—
Final
PASS FART FAIL -----
PLUMBING —
Post&Beam --- ------_ _-_ -_ --
Under Slab
Ton out - -- —
Water Servir:e
Sanitary Sewer - ---- ---- ------ ---
Rain Drains
Final ----_--
PASS PART FAIL. _- _.-- - 11L1A - —_
MECHANICAL
Post&Beam — - ----- - -�� ---
Rough In
Gas Line —_ — —
Smoke Dampers __-
Final
PA FAIL
Rough In
UG/Slab
Low Voltaqe
Fire Alarm -- - -----_—�--- --___— _`
Final
PASS PkRT FAIL.
Backfill/Grading -----
Sanitary Sewer
Storm Drain [ )Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinspection RF: __ — [ j U cable to inspect no access
ADA
Approach/Sidewalk
Other Date �2�__-_- Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CI1Y OF
TIGARD MASTER PERMIT -
PERMIT #. . . . . . . . MST96-01 .1. :
DATE ISSUED: 03/26/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,(Dragon 07223.8199 (503)639-4171 PARCEL: 2S 104CC-03600
ITE ADDRESS. . . : 13958 SW FAILLSHIRE DR
SUBDIVISION. . . . : H I LLSH I RE ESTATES NO. 2 ZONING: R-7 PC,
BLOCK. . . . . . . . . .. . L-OT. . . . . . . . . . . . . .
Remarks: PATH I
---------------------------------•---------------------------- BUILDING -----•------------•------------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUITED SETBACKS---- RE(UIRED--------
CLASS OF WORK.:NEW HEIGHT........: 32 FIRST....: 1406 sf GARAGE—-: 656 st LEFT..........: 14 SMOKE DETECTRS: v
TYPE OF USE...:SF FLOOR LOAD..,.: 46 SECOND...: 996 sf FRONT.........: 20 PARKING SPACES: I
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 11
OCCUPANCY GRP.-.R3 BDRM: 3 BATH: 3 TOTAL.-----: 2404 sf 1ALJE..1: 166661 REAR..........: 60
-------------------------------------------- -------- PUUMdING --------------------------------------------------------------
SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..: i LAUNDRY TFAYS.: i RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 4 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH hASINS..: 0
TUB/SHOWERS...: 4 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------------------------------•------------------------------- MECHANICAL ----------------------------------------------------- ...
FUEL TYPES----------- FURN l 188K ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 1
/GA5/ / / FURN ,=10%k .. : : UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: I
MAX INP.: 8 BTU FLOOR FURNACES: 0 VENTS.........: 8 WOODSTOVES....: 0 GAS OUTLETS...: 1
-.-----—--------------—--------------------------------- --- ELECTRICAL --------------------------------------------------------------
—RESIDENTIAL UNIT--- --SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADO'L INSPECTIONS--
1000 SF OR LESS: 1 8 - 200 amp..: 0 0 - 280 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5805F.: 5 201 - 400 amp..: 8 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 :;ION/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 8 481 - 600 amp..: 6 EA ADDL BR CIR: 0 FIGNAL/PANEL...: 0 IN PLANT......: 0
MAW HM/SVC/FDR: 0 681 - 1808 alp.: 0 601+a1ps-1080 v: 0 MINOR LABEL -10: 0
1088+ amp volt.: 0 ---------------------------------- PLAN REVIEW SECTION ------ ---------------------_
Reconnect only.: 8 )=4 RES UNITS..: SVC/FDR)-225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
--------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ----------------------------—-------------
A. SF RESIDENTIAL-------------------------- B. COMMERCIAL----------------------- -------------------------- ---------------------
AUDIO d STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOMMAGING: OUTDOGR LNDSC LT:
BURGLAR ALARM..: 0TH: :: X BOILER,.........: HVAC...,.......: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK........... INSTRUMENTATION: MLDICAL........: OTHR: ::
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL M SYSTEr3:
Owner: -----------------------------------Contractor: ----------------------------- TOTAL FEES:$ 4084.96
WINDWOOD FLIES INC WINDWOOD HOMES
14076 SW BENCHVIEW TERR 14076 SW BENCHVIEW TERRACE
TIGARD OR 97224 TIGARD OR 97224
Phone N: 590-4700 Phone 0: 590-47M
Reg 0..: 058196
This nermit is issued subject to the regulations contained is: the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. Al; N- • M:l': be done in accordance with approved plans. This permit will expire if 4ork is not started within 160
days of issuance, or if work is suspended for more than 180 days.
---- --------------------------------------------------- REQUIRED INSPECTIONS ----- ------------ -------_..__...---------- ----
Footing Insp PLM/Underfloor L000 Voltage Gyp Board 1rsp Electrical Final
Foundation Insp Mechanical Insp Fireplace Insp Rain drain Insp Mechanical Final _
Post/Beam Struct Plumb Top Out Gas Line Insp Water '.ine Insp Plumb Final
PoStrDeam Mechan Electrical '�etvi Gas Fireplace Water Service In Building Final
S
ulathon nsp Appr/Sdwlk Insp t o1
awl Drain Framing n ns r- --
y P
I er-mittee �> gnatliv;e4_
• __-.. _ Is stied Ley : � �ll for inspection -- 639-4 175
i
SEWER CONNEC ION
PERMIT
CITY OF TieG—*4ARD PERMIT
#. . . . . . .
: SWR96—LAILIS
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 03/26/96
13125 SW Hall Blvd.Tignd,Oregon ,07223.8199 (503)939-4171 PARCEL: S104CC-03600
SITE ADDRESS. . . 1 13958 SW HILLSHIRF_ DR
SUBDIVISION. . . . t HILLSHIRf_ESTATES NO. 2 ZONIN3: R--7 PD
P-1_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 142
TENANT NAME. . . . . e
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remark s . PATH I
ONner: -._---•-------.___._. _-___,___._.__.___._..______..__.__.- FEES --_ ._....__.__.____.__
WINDWOOD HOMES INC type amnl-Int by date r~er_pt
14076 SW BENCHVIEW TERR PRMT $ 2200. 00 FON 03/C-6/96 96-277442
INs.,P $ 35. 00 BON 03/`b/96 96-277442-
1' 1 CARD OR 97 :24
Phone #: 590--4700
Cant-actor.-
CONTRACTOR
ant-actor:CONTRACTOR NOT ON FILE
1 I .r n e #: $ 2235. 00 TOTAL
--- -----
REQUIRED INSPECTIONS
--
This Applicant agrees to comply with all the rules and regulations fewer Inspection
of the Unified Sewage Agency. The permit expires 190 days from _
the date issued, The total amount paid will he forfeitbd if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is iot located at the measurement
given, th; installer shall prospect ? feet in all directions from
the distar-e y.,•-. 'f not so located, the installer shall purchase
a "Tap and Side Sewer' Persit and the Agenc iaiDstall a lateral.
rermittee/ Sig atl.ii eidw
Call fat~ inspection 639 4175
TTZ
�- F;e;:iden_tial Building Permit Application
City of Tigard
13175 SW Hall Blvd. wa 96
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 3 S �S�J �JrI) lit Nr
t_-
Subdivision: . / `Lot#1tI_ Office Use Only
Valuation:
Contact Date / ! Initials
—_
Result
New Construction Only: (Square Footage) /I Planck,'Rec #
House: --�` O� Garage: �� 5 v' Permit # ill
Reissue of _
Corner Lot? Y Flag Lot? Y 'n Map & TL # 7��t ;ice o Sc••�>r >
"�' Zone f
Owner: wrb 1 �fJn+��_d A ( Plat # Q!-(9
L �r ._ APprovals Required
Address � l(,t
Planning Setbacks ''` Solar Nt"
•n »�',H - Engineering rcjC2 7 S ,Phone fir., T c1/r
Other
Contractor- Items Required
AddressSubcontractors
--_.- — - --- --- Truss Details
Other
Phone. ( ) Notes
Contractcr's License
(attachiopy of current Oregon license)
Contact Name:
Contact Phone
Subcontractors: Architect/Engineer: L"
Plumbing: _ \ ;'in 5 JV/ _— Address: N '641Y /yS'N
Mechanical: _ "tom_ d''r _
(attach copy of current OR Contractors License)
Inc t (` y Phone:
JOB DESCRIPTION:
Appka'nt Signature ) ` Applicant phone number
Received by Date Received
Permit S Account Oesc:iptlon Amount Amt, hi. Bal. Due
—ell 3 Bldg. Penric (BUILD)
Plumb. Permit (PLUMB)
Mach. Permit (MECN) `W --
Bldg; 30-0 3
Plumb:
Mach:
`IL
c � =�
Plan Check (PLANCK) Z j L U
Bldg:
Plumb:
Mech: Z z
t� Sewer Connection (SWUSA) Iva
Sewer Inspection (SWINSP) 3J
Parks Dev Charge (PKSDC)
Residential TIF MF-R)
Mass Transit 'TIF (TIF-MT)
Commercial TIF MF-C)
Industrial TIF (TIF-I)
Institutional TIF (TiF-IS)
Office TIF (717-0)
'Nater Quality (ViQUAL)
Water Quantity (WCUANT)
Fire Life Safety ;FLS)
Erosion Cntr1 Permit (ERPRMT)
Erasion Planck/USA (ERPLAN)
4
cresicn Plan6JCO T (ER OSN) 2t S-z
TOTALS:
6� 3 ► I-q �
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT*
13125 SW Hall fli,,ld., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PL.M96-0227
DATF ISSUED: 11/12/96
PARCEL-: 2SI04CC-03600
SITE ADDRESS. . . : 13958 SW HILLSHIRE DR
SUBDIVISION. . . . : HIL_L.,Y1IRE: ESTATES NO. ZONING- rq--'7 PIT)
BL-OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . 142
---------------------------------- ----------------------------------------------------
CL.ASS OF WORK. . :OTR GARBAGE DISPOSAL.S. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : I
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . ., . . 0 TRAPS. . . . . . . . . . . . . . . 0
";TORIES. . . . . . . . : 0 WATER HEATERS. . . . . . 0 CATCH BASINS. . . . . . . .. 0
FIXTURES L..AUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . : 0
L-AVATORIES. . . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER Cl-OSETS. . 0, WATER L.I NE (ft ) . - - - 0
DISHWASHERS. . . . 0 RAIN DRAIN (ft ) . . - : QA
Remarks : Installing residential backflow prevention device
Owner: FEES
WTNDWOOD HOMES INC type amolint by date V-ecpt
t4076 SW SENCHVIEW TERR PRMI $ 15. 00 B I1/12/96 96-266334
SPILT $ 0. 75 B 1 t/1 ,1
2/96 9-6--1 '8633
1IGARD OR 97224
Phone #: 590--4700
(;ontr-ar_tov-:
CEDAR LANDSCAPE
14375 SW PATRICIA AVE
1-111-LSBORO OR 97123
Phone #: 503--62B-3411 $ 15. 75 TOTAL..
Peg #. . : 5843 REDUTRED INSPECTIONS
---
t'iis permit is issued subject to the regulations contained in the RrI/BaCPf1UW 'rev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordarre with
approved plans. This permit will expire if work is not started
within 180 days of issuarTe, or if work is susaerided for wore
than 180 days.
Per,mitt-e S' a t s.j v-e
Cal 1 for inspection 639-4175
L
CITY OF TIGARD Plumbing Application Recd By A
131,25 5VV HALL BLVD. Commercial and Residential Date RecdDate to P.E.
TIGARD, OR 97223 Date to DST
(503) 639-4171 Permit f'I.M ° L- 03-5?
Print or Type Related SWR s
Incomplete or illegible applications will not be accepted Called _
Name of Devlopment/prolectT z'�alt" 5,y4,4
'Fee"$'hBidATt:dHe¢s�HiOdUStE-buu,po'}ealx0eJob ;u3r'eaeAIrl tl►"e alr7;ci the l�rsui l
Address Street Address Suiteoo i�sat ofr�
TH'H01 00 � '
r
Bldg s Crtyistatep QZip water service,sanitary sewer and storm sewer..Se,,feee'below i-.
Name FIXTURE,, (individual) OTY PRICE AMTS
i
V✓/✓owe'Vel. '-le/cf t3 Sink — 900
Malin Address Suite ---� -�
Owner 9 Lavatory 9.00 'tl
Tub or Tub/Shower Comb 9.00
City/Slate Zip Phone _
Shower Onlv —�Y— — 900 —�
Name Water C'jset 9.00
Dishwater 900
Occupant Melling Address Suite Garbage Disposal 900
_ — Washing Machine 900
City/Slate Zip Phone Floor Drain 2 — 900
3
Name 9-00
� /
6�o'4R 1-'gNdSr'xe 14k _ _ 4" 9.00
Contractor Madiny Address Suite Water Heater 9.00
}(.t,'AlfAk"c>.e �7f'~ Laundry Room Tray 900
CityiState Zip Phone --- -
Urinal 900 J
Oregon Const.Cont.Board Lic.0 Exp.Date Other Fixtures(Specify) 900
Attach Copy of Sb'g3 �, 77 _ goo —�
Current Plumbing Lic, Exp.Date — i 9.00
License /„"7 3,75 'g Sewer- 1st 100” -- 900
COT Business Tax or Metro a Exp, Date Sewer_each additional 100' 30.00
Name Water Service-1 st 100'+ 2500
Water Service-each ad6itionai 200' 30.00
Architect Mailing Address Swte Storm&Rain Drain-1st 100' 2500
or Storm d Rain Drain-each additional 100' 30.00
Engineer Oity/State Zip Phone Mobile Home Space — 2500
Commercial Back Flow Prevention Device or Anti- 25.00
Oescnbe work New C Addition O Alteration O Repair O Pollution Device
to be done Residential O Non-residential O Residential Backflow Prevention Device' 15.00
Additional description of work Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 900
—.l
Insp.of Existing Plumbing 40 00
- ---- —.� _ per hi
Existing use of Specially Requested Inspections 4000
building or property—_,_` _ per hr
Proposed use of Rain Drain,single family dwelling 3000
budding or property___._____ Grease Traps 9.00 I
Are you capping any fixtures? Yes C^_No p QUANTITY TOTAL 4A:gs' `I
- .'. ..:...
I hereby acknowledge that I have read this application,that the information Isometric or nser diagram is required if Quanrty Tolal,s >9— 'SUBTOTAL - - -��•
given is correct.that I am the owner or authonzed agent of the owner,and � ."
that plans sunmitterl are in compliance wdh Oregon State Laws -- -- 5% SURCHARGE
Slgr Ature of Owner/Agent �— — Date
( •GLS C �,J,V� % , 1. ` PLAN REVIEW 25% OF SUBTOTAL r. ;
Requited only A fixtu.a qty total�s>9
Contact Person Nam Phone — TOTAL
— - 'Min,hnum permit tai is$25,5%surcharge,except Residential Backflow
i\dsts\plmapp doc
Prevention Device,which,s S15 �5%surcharge
} CITY OF TIGARD
DEVELOPMENT SERVICES EL.ECTRT.L`A(_ PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171 PERMIT fl : ELC96-0121
DATE ISSUED: 11/12/96
PARCEL: 2S 104CC-0::x600
;1 !"E ODDRESS. . . : 1 '3958 SW H I L.I__SH I RE DR
SURD I V I S I ON. . . . : H I l_.LSH I RE ESTATES NO. Z ON I NG:R-7 PD
BLOCK. . . . . . . . . . I_.()T. . . . . . . . . „ . . . : 142
r'r^oject Description: Installing residential irrigation circle
......_.-__-.__._--..__..._.._.__
--RESTDENTTAL UNIT----- ----TEMP SRVC/FEEDERS---- -MTSCELLANE:C:II]5---
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 1
FACH ADD' L. 50QISF. . . : 0 x'01 400 am SIGN/OUT LINE LTG. . : 0
L.IMITFD ENERGY. . . . . : 0 401 - 6;00 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601+amps--1000 volts. : 0 MINOR I.-ABEL ( 10) . . . : 0
-.._--_SERV]CT_/FELDER---- .---- BRPNCH CIRCUITS------- ---ADT)' L INSPECTIONS-_ -
0 — ;x'00 'zimp. - • . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 — 4.00 :imp. . . . . . : 0 1st W/0 SRVC OR FDR. : 17! PER HOUR. . . . , . . . . . . • 0
401 - 600 amp. . . . . . : 0 EA ADD' L RRNCH CIRC: 0 IN PLANT. . . . . . . . . . . 0
V'OI 100k' amp. . . . . : 0 _..___..___ _._____-_...._...__.._C:'(.A14 REV IF.-W SECT ION- __-_____._..__._._..__._ _--
1r100+ amp/volt. . . . . : 0 ) r4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect on],y. . . . . : 0 SVC/FDR > = ;_25 AMPS. . : CLASS AREA/SPEC OCC. :
0wner- . ___.___._________.______._______...–____.__._.._.__._ FEES
WINDWOOD HOMES INC type amoi_int by date— _ 'recpt '
14076 SW BENCHVIEW TERR PRMT ! 40. 00 B 1. 1 /12/96 96-1286?.34
! IGARD OR 97c't'4
SPCT 00 B 11112196 96- 286,-34
Phone #: 590--4700
Contractor:
,EDAR LANDSCAPE: $ 42. 00 TOTAL_.
14:75 SW PATRICIA
REOU 1 RED T NSPECT I ONS
HILLSB(-)RO OR 97123 Undergrol_incl Cove Elect' 1 f=inal
Phone #. 503- 628--3411 Elegy t' 1 Service
Reg #. . . 15'8413
This pereit is issued subject to the regulations contained in the -
Tigard Wunicip,l Code, State of Ore. Specialty Codes and all other- F'erm i.t t ee
Si.gnntt!r^e
applicable laws. All work will be done in accordan•e with
approved plans. This pereit will expire if world is not started
within 18N days of issuance, or it nark is suspended for Bore
than lot 6.iys. Issued Ry
----_----_— ___.._.__..._---------
INSTALLATION
The installation is being made on property I own which is not intended for
s.'Rle, lease, or rent.
OWNFRIS SIGNATURE: _ DATE-
INSTALLATION
ATE:INSTALLAT]ON ONLY_.___--.-•----___
SIGNATURE' OF SUPR. EI_EC:' N: DATF-
L I CFNSE. NP:
Call for inspection -- 639-4175
CITY OF TIGARD Electrical Permit Application Recd Check t t �}
13125 SW BALL BLVD.
Date RecdI r
TIGARD OR 97223 -!1.
Date to P.E.
Phone (503)639-4171 x304 Date to DST
Inspection (503) 639-4175 Print o�Type Permit 11 r LC ���-!
Fax (503) 684-7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Compleie Fee Schedule Below:
Name of Development���/�Sl�� s�i�yCS Number of Inspections per permit allowed
Name(or name of business) (Vd 0"'(,)aa Service Included: Items Cost Sum
Address ./J!�j r!v /��'�''hr �'Cry 4a. Residential-per unit
_ 1000 sq.11.or less $110.00 4
City./State/Zip '/�//�Ie�) LSC', _ Each additional 500 sq ft.or
❑ portion thereof _ $25.00 1
Commercial ❑ Residential
Limited Energy � $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder ^_ $68.00 2
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractoi C`C D%,49 4.13A'JSCV!r!L Installation,alteration,or relocation
Address SL��fiTr.�'iciR iw� 200 amps or less $60.00 2
201 amps lo 400 amps $80.00 2
City` �� tate e" _Zip 401 amps l0 600 amps $120!X) _ 2
Phone No._r :. -J 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
Job No,
Elec.Cont Lice. No. Exp.Date_ Reconnect only $50.00 2
OR State 17-C6 Reg. No._1"842 Exp.Date-_. y 7 4c Temporary Services or Feeders
COT Business Tax or Metro No. `-Exp.Date Installation,alteration,or rAcuation
200 amps or loss $5000 2
Signature of Supr. Elec'n-^ �c�^e '`"� - 201 amps to 400 amps - $75.00
401 amps to 600 amps $1!10.00 2
Over 600 amps to 1000 volts,
License No.., -�a j�'S Exp.Date '�� M see"b"above.
Phone No. r�.-'�' �9//
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase or service or
Print Owner's Name_____ _ feeder tee.
Address �_ Each branch circuit $5.00 2
h)The fee for branch circuits
City__ _ State _ Zip without purchase of
Phone No. _ service or feeder tee.
First branch circuit $35.00 2
The installation is being made on property I own which is not I ach additional branch circuit $5.00 _ 2
intended for sale, lease or rent. 4e.Miscellanpous
(Service or feeder not included) ,q O
Owner's Signature_ Each pump or irrigation circle $40_1_ 00 2
Each sign or outline fighting $40.00 2
3. Plan Review section (if required):* Signal clrcult(s)or a limited energy
panel,alteration or extension $40.00
'.livor Lab,d!S(10) $100.00
Please check appropriate Item and enter fee In section 5B.
4 or more residential units in one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $3500
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E C.Chapter 5 In Plant $55.00 _-
"Submit 2 sets of plans with application where any of the above apply. b. Fees: 10 e e
Not required for temporary construction services. 5a.Enter total of above fees $ -
5 Surcharge(05 X total tees) $
NOTICE Subtotal $
~^ 5b.Enter 250.of)ine 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUT11ORIZcD IS Plan Review it reouired(Sec 3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
iS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY cx
TIME AFTER WORK IS COMMENCED ❑ Trust ACCOUnt#_ S •� 1
Total balance Due
I WSTMELC96.APP nm ME