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---EIGHT FOOT UTILITY EASEMENT ALONG
FRONT AND REAR LOT LINES.
--ROTATE HOUSE AND FLOP PER RANDY SCALE DRAWING t10-06-94, BTA. LOT 27 RENAISSANCE SUMMIT
--CHANGES ON FOOTPRINT AND SITE S.E. 1 /4 SEC.10,T.2S.,R.1W.,W.M.,
PLAN, 12-22-94,SFF. CITY OF TIGARD .Y...
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' 15421 SW Mazama Place WASHINGTON COUNTY, OREGON
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REVISED DECEMBER 22, 1994 Centerline Concepts
oncepis Inc .
DRAWN BY: SPF CHECKED BY: WGDIII
SCALE 1 "=20' ACCOUNT 115 640503n650-01A8Drive lafox� 5 503 6 —stne, Oregon97027
. 0 01899
If this notice appears clearer than the
document, the document is of marginal duality. MAY 1 91997
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CITY OF TIGARD BUILDING INSPECTION NOTICE
l inspection Line. 639-4175 Business Phone: 639.4171 >i
Footing Rain Drain Cover/Service INA
FCeiling
oundation Water Line °`"
Post/Beam Mech, Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Plbg. Top Out Insulationy t,,
Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg. �� t
San. Sew Gas Line Appr/Sdwlk Reins. "' "«
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Other: �D �-t-f.Q f a
Date: ,� 4 - 9� A.M.'
Entry:
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Tenant:
/��----�-. - -` Ste: MST
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PLM.
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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CITY CSF TIGARD
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COMMUNITY DEVELOPMENT DEPARTMENT F'L_l.1M13 I NG PERMIT y �
13126 9W Hall Blvd.Tigard,Oregon 97223*8199 (503)830-4171 ).
PERMIT #. . . . . . . . PLM'-'.o5-0302
t=, 4171. DATE ISSUED: 10/12/95 "
PARCEL: 2S 1 10DA--0.3600 ,fib.
SITE ADDRESS. . . : 154,2:1 SW 11AZAMA PL
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :027
CLAS OF WORK. . :NEW GARBAGE DISPOSALS. . : MOBILE HOME SPACES. : b
TYPE OF USE. . . . :SF WASHING 11ACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R.:, FLOOR DRAINS. . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : CATCH BASINS_ _ . •
F I X'TURES- ---------__._.._ LAUNDRY 'TRAYS. . . . . . .. SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . " CREASE TRAPS. . . . . . . .
LAVATORIES. OTHER FIXTURES. . . . . .
TUB/SHOWERS. . . . . SEWER LINE (ft ) . . . . .
WATE " CLOSETS). WATER LINE (ft ) . . . . :
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
1 Rpmarks : Install r-esidential backflow prpvpntion device
IOwner-: ___..-.___.._...._.._.__._._._.._._____._.._...__. FEES --
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RENAISSANCE CUSTOMHOMES INC tyle a m o .lnt by nate rocpt
i 1672 WILLAMETTE FALLS DR, VE PRMT $ 15. 00 JSD 10/12/95 95--271592 4
JPC'.T $ 0. 7a JSD 10/12/95 97--2I1592 R' ~
WEST LINN OR 9706B
Phone #: 557--8000
Contractor
MOODY FNTE.RPRISE, INC.
P. O. BOX 98
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ESTAC;ADA OR 97023
Phone #: 631-2-1418 15. 75 TOTAL
Reg #. . : 5973
RE:QUIRED INSPECTIONS ------
This permit is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more __ ___•_�___ ________ ___________..__
than 180 days.
Permittee Signatiq-e:
1
.Issi.ted By :
Call for inspection - 639-417 ;
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
13125 SW Hall Blvd Permit # �LN? 9,-o t°�
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Single Family Residences Only
Bd/,S
,lob /�' L / cif Z 27 ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Address cAwue. ` /' ❑ 3 BATH HOUSE$225.00
zo Fee includes all plumbing fixtures in the dwelling and the first 100 feet
y7 of water service, sanitary sewer and storm sewer. See tees below.
FIXTURES
QTY PRICE AMT
Jels.-dfA-C't, Sink 9I,J
Mm"Ads.« Lavatory
d.To—
Owner Tub or Tub/Shower Comb. 9.00
Shower Only
/ 9.00
Water Closet 9.00
Dishwasher
_ 9.00
OccupantGarbage Disposal 9.00
M Ad*— Washing Machine
9.00
cowFloor Drain 9.00
��� zp Water Heater
—906--
Laundry
00Laundry Room Tray 9.00
N.m.
Urinal 9.00
��/ r v Other Fixtures (Specify) 9 0Q
M8"Ad&— ' Phan.
Contractor
Y ���`2 Y!� 900
CAA,. _ 9.00
Ole-
� zip
Q C - - 9.00
/`- 7U 2.. Sewer 1st 1�, � 30.00
Sim.RsO.n~N.
`" R.. '"N. Sewer-ea. Addit. 100' 25.00
J �I 3 �l�Jf J Water Service Ist 100' 30.00
I hereby acknowledge that I have read this application, that the -
information given is correct, that I am the owner or authorized agent of Water Service ea. Addit. 200' 25.00
the owner, that plans submitted arP +- rompliance with Slate laws, that Storm 3 Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the
y number given Is correct. (It exempt from State registration, please Storm 8 Rain Drain Addit. 100' 25.00
give reason below.) Mobile Home Space 25.00
/� Back Flow Prevention
� Device or Anti-Pollution Device 9 00
lqun..�.rnw or.p.mr U.0 Any Trap or Waste Not
Connected to a Fixture _ 9.00
Describe work new U addition (� alteration U repair C) Catch Basin
to be done residential —
9.00
(� non-esidentlal U Insp, of Exist. Plumbing 40 OU/hr
Existing use of Specially Requested Inspections 40.00/hr
building or property Rain Drain, single family dwelling 30.00
— Y Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential bacMlow -
prevention devices)
NOTICE 'Minimum Fee $25.00 Sl1BTUTAL. r
PERMITS BECOME VOID IF WORK OR CONSTRUCTION -
AUTHORIZED IS NOT COMMENCED WITHIN 190 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED PLAN REVIEW 25% OF SUBTOTAL
Special Conditions
TOTAL
—_ _ Date i,3sued by -`--
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NAME o htl.rrll')Y hldiF fel>1�1 ,L + 1fl r r, ftl'4Gat)I+1 a I
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PLUMNINC-#' PFkrfl
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CEPTIP ICATE^ OF
C11Y MJF TI
C EJCCLJP4aNGY
PERMIT #• • • • • • • MyT95-471016
c DATES ISSUE-De 09/07/9'-
COMMUNITY
9/1247/5'
COMMUNITY DEVELOPMENT A NT
13126 8W Hall Blvd.Tigard,Orpon 07223.9199 (603)630-4171
PARCEL;
SITE ADDRESS. . . a 1.5421 SSW MALAMA PI.-
5UPDIVISION. . . . i RENAISSANCE SUMMIT Z(JNING:R-'3. 5
BLOCK. . . . . • • • Y e LOT. . . . . . . . . . . . . X0217
t.LAi;5—faF�WORK. a NEW
(YPEr OF USE:. . . e SF
OCCUPANCY GRP. 03 j
OCCUPANCY LOAD e x'19 4 j
TENANT NAME. . . :
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Remarkse PATH I
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RENA I SSI)ANCE CUSTOM HOMES IN;--
1.672
NC1.F72 WILLAMETTE FALI_.�; DRIVE
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WEST L.INN OR 97068 i
Phone ;1#e 557-8000
contr-actor.
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RENAISSANCE DEVELOPMENT
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167 5W WII_LAME'TTF.' I'-AL..LS DR
WEST LINN OR 9706£1
Phone #e 577 -8000
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Rey #. . a 49155 1
Phis Certificate certifies that the above referenc-ed b4.1i. lding ar portion
thereof has been inspected for, c::omplianc.e with the Tigard Suilding Code
for th<. group And divi.sion of oc.cupancy and use for whish the as ovn �
referenced permit was isa4_ted, and or_c"uparicy. is hereby gr-antPd.
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-T'E L"TORSUI I L7FFIC:IAL
POST IN CONSPICUOUS PLACE
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-U-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line B dg.:
Plbg. Underfloor Rain Drain Framing um .�
Alarm Water Line Insulation • ec .)
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
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Date Requested: -7 Time: AM PMS
Address: / :� L �Y ���- 1"Yt-C .
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Builder: Permit #: / `a
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Insp for _ Dater
PROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE 1
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-PhoneL639-4175 Business Phone: 639-4171 � lfir'4
Inspection: �f A/444,_ frslPt 1 `�I alb x
Footing Susp. Ceiling Sprink. Rough-in
Foundation Plbg. Underslab Mech. Rough-in Fireplace
y '•. Y I� 1�C 1�y�Z'ft rA� 1-.
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall GYP. Bd. -Elect.
Date Requested: l , �/ 7/�1 '� `Time: AM PM
Address:_— �f % L.
Builder: v
Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date:_
_APPROVEDkIDISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE F
Inspection Lire (Rec-O-Phone): 639-4175
Business Phone: 639-4171
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Inspection:
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Footing Susp, Coiling Sprink. Rough-in Appr/Sdwlk
Foundation
Plbg, Underslab Mach. Rough-in Fire lace .� �� `
Post/Beam Struct, Plbg. Top Out p
Elec. P.ough•in FINAL:
Post/Beam Mec',.
San. Sewer Gas Lina
-Bldg.
Plbg. Underfloor Rain Drain ;
Alarm WaterFraming -Plumb.
Line Insulation
Mach.
Underilr. Insul, Shear Wall
Gyp. Bd.
C.
Date Requested:
Time:_^AM pM dI ill'
Address:
Builder:
�errnR�#-''r��c)G r�Y
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THE FOLLOWING CORRECTIONS ARE REQUIRE
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Date;
," PPROVED x '
__,_DISAPPROVED APPROVED SUBJECT TO ABOVE �
a, _Call For Reinsp. f
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CITY OF TIGARD BUI°.DING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): (39-4175 Business Phone: 639-4171 "iA ,r� Q Ir4�k4,
Inspection-_- -[�,(r1' 12a
Footing Susp. Ceili, . R
g Sprinkough-in Appr/Sdwlk ;! i' �r ,'„
Foundation Plbg. Underslab Mach. Rough-in Fireplace ���yy
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg o
Plbg, Underfloor Rain Drain Framing -Plumb. ;it
Alarm Water Line insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
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Date Requested: Time: AM PM ,
i Address: y2 I X 0 y0_, C_
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Ins or: Date:
APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For For Reinsp. a';1,
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417
t_/Q/—��
Inspection:
Footing Susp. Ceiling Sprink. Rough-in r/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Radm Struct. Plbg. Top Out Elec, Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �!� (.� /�) Time: AM PM
Address:__z V l CL Q_ y ) Lez
Builder: _)Permit k: %� . —C:�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector ` ' Lt �G � ;at__ _APPROVED DISAPPROVED PPROVEDUBJECT TO ABOVE
Call For Reinsp,
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CITY OF TIGARD BUILDING INSPECTION NOTICE 2 r1
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639- 171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in .
P r/Sdwlk
Foundation Plbg• Underslab Mech. Rough-in Fireplace
Post/Beam Struct, Plb To Out
9• P Elec. Rough-in FINAL:
Post/Beam Mech. San. Sower Gas Line -Bldg
Plhg, Underfloor Rain Drain Framing -Plun,b.
Alarm Water Line Insul •
rin .1 Bch.
Underilr. Instil, Shear Wall `Gyp. Bd 1�
-Elect.
Date Requested:— � Time• VAM PM
Address:
Builder:_ �C��riG Permit
THE
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date:
PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE Mr `
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 634 1 i
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr Ik w
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg, Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing .-Plumb.
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Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall
-Elect.
Date Requested: S Time: AM P6L
Address:
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Builder: Permit — OCU
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date: �S
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' LIP—PROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41,
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Ap dw k I
Foundation Plbg. Undeislab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
is
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line =d.
-Mech.
Underflr. Insul. Shear Wall -Elect.
Date Requested: Time: AM PM
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Address: / Sw /'�i� 14- l�
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Builder:_ C/1,V(° Permit #:
44
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�V" t THE FOLLOWING CORRECTIONS ARE REQUIRED: 4
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Inspector: Date: S
( !l• PROVED —DISAPPROVED —APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12 �f
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
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Permit # : 05065954 Project. # . Pu048875 r:t.atus AIYPRQVED Page 1 of 1
Applied : 04/04/95 Issued 04/04/95 Expires 10/01/95 05/03/95 05 : 01
RESELEC
Permit Title SFv - NEW 1-1011SP UT11
Description Aequn : 04/04/y5
Joky Address 15421 nW MAZAMA PL TT /�/
Owner Nam* I NZI PELT I ON - T I GARI) Q 4rf /, o e vw- 1
Req I on �)
Applicant. Name GAGE ENTERPRISE"j INC
Phone number 657-0142 VHluatIon 0 Approved.__
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Inspector Commgnts Re.j,.cte3
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REQUEST ERROP
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St.ructrual :
c3enera.ICCA 1401
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Inspection Req ,ested � no
+ Craver & Service Q0�;(,:1 ! i:� �1 � i� Q va� {l��i�PCON
05/03/45 R1 1, J ��
04/28/95 III Na{ C-7c�{i qV Q �v PPO kc4f 4 w he_ ow (I r, �5
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DEPARTMENT OF LAND USE do TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit # : 05065954 Pr j&rt 11 : P0048875 St.atwl APPROVED Pager I of 1
Applied : 04/04/95. Issued 04/04/95 ExpirEj�, 10/0 .1 /145 05/0,/95 Obi 02
RE.'ELEC:
r Permit Title :`FR - NEW H01-1 9,E OTH
Description ^^AF NP Begmn - 04/04/95
Job Addr&rs 1x1421 LW MAZAMA P � 'v
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j owner Name INS-PFCT I 10N - T I GARD Regi cin
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Applicant Name _;AGE ENTERPR I SE rr INS!
Phone number 6'�7-0142 valuat_ic,;, : (a App raved_i
Inspector Corrunents
i VR-RESULTS
RECAIEST ERROP I
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:
Plumbing
j M e c h a n i c a l
S di,
Electrical :
nt.ruct.rual
r3*neral
Inapoacted by _ ..�_ ...___ _... _...- Date
Inspection Rpgupsted --1 �-
Covor 5 S*ry it.•> 040.4 E (AP ) r�N
0 i I1VI: 3- ` Rr' E '
5/ R 12 . .
t)5/A:3/95 RI 1,11
05/0:3/95 PN H;: DNIVR LUT7
04/28/95 RI 1*1i
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Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 171
kb, Inspection: _
Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
4 i Footing
i��`-r,4/ Foundation *P'bgAderslalb �`Pf'A6'Cl>,�t7t-- Fireplace
Post/Beam Struct. Elec. ough in FINAL:
-Bldg.
Post/Beam Mech. Gas Line
Plbg. Underfloor Rai r in rami0 Plumb.
Alarm ne Insulation -Mech.
Underflr. Insul. 1' Gyp. fid. Elect.
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Date Requested:
� 5 ^) /%��y, Time:�AM PM
of
Address: ��T C�� sem✓ /� ��1"
AS ifBuilder: ,ii_,i'y s��%"�' c' Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�Tl i� Qc�,� d��cr,•y� ,
LLQ'
7-4
71
InspActor: _ Date:_
APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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i CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:../-'6 1
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
I Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm 1 ine ' Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
/. -
1 Date Requested: �,%/� J��>Ij"- Time: AM oL_PM
I Address:��Z217/��'/,' ,�J
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1 Builder: Permit #:
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector Date: i'
(A ROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE — x
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:
Inspection Line (Rec-O-Phone): 639-4175 Business Phone639 17
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. SewerI
Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm ter L' a Insulation -Mech.
Underflr. Insul. hear Wall Gyp, Bd. -Elect.
Date Requested:- / Time: AM �PM
Y
Address: /syr s�_,� /�A , �,�►
Builder:_ Pei mit #:�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Insp�ecc Data.
P -
ROVED DISAPPROVED __APPROVED SUBJECT TO ABOVE
_Call For Reinsp,
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 17
2
Inspection: r 7
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Footing Susp. Ceiling Sprink. Rough-in pr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. b . ToP-0 u-t Elec. Rough-in FINAL:
Post/Beam Mach. San, Sewer Gas Line -Bldg. r
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm star Line Insulation -Mach. +
Underflr. Insul, Shear Wall Gyp. Bd.
-Elect.
Date Requested: Time: SCAM PM
Address: /'e)-G12 A7A-z
Builder._ ��FNG Permit #: ✓JEST
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: /
_ pate:
PROVED ,DISAPPROVED _APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
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DEPARTMENT OF LAND USE 8 TRANSPORTATION
' WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,F I
ORO,OR 97124
COUNTY INSPECTION REOUESTSBa03 /640-3561/693-4415
OREGON XXXXXXXXX--> 640-3470
Page 1 of 1
Late 04/U4/95
Time 14 : 02
Permit `Typtr Residential Electrical Permit. Permit. # s 051165954
j Permit Status APPROVED Applied 04/04/95
Situs Address 1b421 SW MAGAMA PL Ti Issued : 04/04/95 a
Permit 'Title SFR - NEW HOUSE Completed ')
Permit Uescr , To Expire 10/01/95
! Project. 'Title :FR - NEW HOUSE Project # : P0048875
Project Uescr. * EROSION * >1
i
Parcel Number 2b1'T1 - Land Use District
i Valuation U
Legal Uescr.
Owner 1N:�PEC'TIUN - Ti(-;ARL) Construction OTH
Applicant Name UAUE ENTERPRISES INC Classification 900 )
Applicant Addr, : PU BOX 1429 Occupancy
1 CLACKAMAS OR 9'/015 Validated by STP'
Applicant Phone: 65'/-0142 inspector Area' I
1 Fee description Units E'ee/Unit. Ext fee Data
1 ------------------------.------------- -------------------------------------------
Square Footage [Enter Sq, Ft , ] 4000 250 , 01)
Subtotal Electrical Fees : 2bU , 00
State Surcharge of b% 13 . UU
Total Electrical Fees : 273 . 00
! -***-_Fees-Required---**+ - -***--- __Fees
-Collected & Credits ***
!, --------•-_------------------
Method Check # Receipt No. Date Payment
CK 1621, 04/04/95 273 . 00
!! VO'1'AL THIS OATS ******* kA 273 . 00
i Fees : 2'/3. 00Aujustments : , U0 'Total Credits : , 00
Total Fees : 2'13 . 0101 'Total Payments : 273 . 00
balance Due : . 00
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NOTICE: This permit becomes null and void If the work or construction for which It Is Isuued Is not commenced within 180 days. Once construction has started,
the permit becomes null and void If construction Is interrupted for a period of 180 days. I-ertlfy that the Information presented by the applicant and
his agent or agents In support of this permit is true and correct it,the best of our knowledge. 1 acknowledge that the Building Department's reliance
upon Islas and misleading Information may Invslldate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or stricture will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or stricture permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy In revocable until all Inspection requirements ars satlslled and
approval is given by the Building Ofllclsl. I further acknowledge that a lien may be placed on the title of the property upon which the permit It Issued
r
specifying that the tits or occupancy of the building or structure Is provtslonsl and revocable until the satisfaction of all Inspectlon requirements.
APPI ICANT'S SIGNATURE
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WASHINGTON COUNTY
Department of Land Use & Transportation ELECTRICAL PERMIT °
Electrical Inspection Sectionll,`,,
t His bo o, Oregon North First Ave97124nue,#350-12
regnVe97124350-12 APPLICATION ,3�t
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g Information: (503)640-3470 Fax: (503) 693-4412 1
Permit
Number• -
Date
Please
s
through 4. Complete Fee Schedule below
k5qI. Location of Inst n Number of Inspections per permit allowed ;,
Address / ? Service included: Items Cost(ea.) Sum
uilding A. Residential-per unit 'k
cityI1ItiU suite No.
Cl
Tenant Name
1000 sq,ft.or less 1 $110.00 1 1 0 4 1
q•Each additional 500 s ft
(if commercial)
1 or portion thereof _�„_ $25.00
Map No, Tax Lot __ Limited Energy $45,00 1
Each Manuf'd Home or Modular `.,
Dwelling Service or Feeder $68,00 _ 2
Thomas Map Book: Page: Section:
Directions------ – B. Services or Feeders
Installation,alterations or relocation
Commercial 200 amps or less $60,00 2
❑ Residential 201 amps to 400 amps $80.00 _ 2
401 amps to 600 amps $120.00 2
2a. Contractor injst llation only601 amps to 1000 amps $180.00 —. 2
. Over 1000 amps or volts $340.00 2
Electrical Contractor 1 '0 Reconnectonly' /1, ' . $50.00 4
Address ,
Date. Job Number C. Tempors,y Services or Feeders
Property Owner ��/i I /t .� ) 7T Installation,alteration or relocation
Contractor's License No. '-', ��— 200 amps or less $50.00 2
Contractor's Board Reg. No. '+ c — 201 amps to 400 amps $75,00 2
401 amps to 600 amps $100,00 2
Signature of Supr. Elec'n ( t_t .' =___ ._ –1 r Over 600 amps to 100n volts see'I3•above
License No. 1 r) Phone No. G 1 ZZ D. Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with i
purchase of servlce or feeder fee,
Print Owwn s a�T-mo Phone No. Each branch circuit $5,00 2
b) The fee for branch circuits without
7� recTd ss — - purchase of service or feeder fee.
First branch circuit $35.00 !_ 2
Iry State Zip i-- Each add'nl branch circuit $5.00 2
E. Miscellaneous (Service or Feeder not included)
The installation is being made on property I own Each pump or Irrigation circle $40.00 2
which is not intended for sale, lease or rent. Each sign or outline lighting $40,00 2
Signal circuit(s)or a limited
Owner's Signature _ _ energy panel,alteration
or extension $40.00 2
F. Each additional Inspection over the allowable
3. flan Review section (if required) in any e the above
Per insppection $35,00
Please check appropriate hem and enter fee In section 58. Per hour _ $5500
�4 or more residential units in one structure In Plant $55.00 —
_Service and feeder, 600 amps or more 5. Fees
System over 600 volts nominal A. Enter total of above fees $ _ �t� O - 043
Classified area or structure rontaining special 5% Surcharge (.OS X total fees) $ ��_.
occupancy as described in N.E.C. Chapter 5 S110
ubtotal
$
Submit 2 sets of plans with application where any of the B. Enter 25% of line A for
above apply. Not required for temporary construction Plan Review if required (Section 3) $ ---
services. Subtotal $
Less Bulk Label Fee $
°
For inspections call Balance Due $
640-3561 or 693-4415 This permit becomes null and void It the work suthorlred by the permit is not commene[d
whin 180 drymor s fro"date of Issuance of such permit or"the work suthorited Is
24-hour recorder, one working day in advance of need Elepended Per: ne non„any time attar work Is commenced for a period of 180 days.
ociricaalundable and non-Irensfereblo.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/ dwlk
Foundation` Plbg, Underslab Mech. Rough-in Fireplace
i
Post/Beam Struc . Plbg. Top Out Elec. Rough-in FINAL: i
MecR` . San. Sewer Gas Line Bldg.
Ibg. Unde Rain Drain Framing -Plumb.
fAlarm Water Line Insulation -Mech.
Undertlr. Insul. Shear Wall Gyp. Bd. -Elect.
-� Date Requested: / %lUTime: AM PM
Address:_,-, rw,'��1�/?
*7 Builder: v>t r',c,4SG , C�C�' Permit #: r
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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`Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
i Fuotin9 Susp. Ceiling Sprink. Rough-in A r/Sdwlk
Foundation FP
Plbg. Underslab Mech, Rough in Fireplace
Fist/Beam Struct, Plbg. Top Out Elec. Rough-in FINAL:
Pos'/Beam Mech, San. Sewer Gas Line
–--�-PIS , -Bldg.
C Inderf�> Rain Drain Framing -Plumb.
Alarm Water Line Insulation
-Mech.
Underflr. Insul. Shear Wall
Gyp. Bd. -Elect.
Date Requested:
Time; AM PM
Address: `> t
Builder: —�—
Permit #: O C�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector// i –=
_APPROVED DISAPPROVED ,APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Depnrtaent
13125 8M Ball Blvd. Tigard, O;cegon 97:2
Inspection Line (Rec-O-Phone)e 639-4175 Business Pn632.4471
Inspection:_
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. 9ewe� Framing -Bldg,
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Plater Line Gyp. Bd. -Meeh.
2EDate Requested: J�/�/.r/s Time: AM PM
Address:-/sy2/ /�//9Z/b/YJ -- Permit
Builder: �PNSr4/iyL''� _= 5ulde 51
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_�_ Det 7
___ APPROVED — DISAPPROVED APPROVED SUBJECT TO ABOVE t
- call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41 1
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Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Ib
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg,
Plbg. Underflooraui19�prai�� Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Tilde:_ X AM PM
Address:1Sy2q 4- —
Builder: �(F.y�SC3/��/y(�,e Pe mit #: /1?ST
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: — Date: WSJ
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
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Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 �!
Inspection: _
I
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk �
undation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: r `1 Time: AM PM
Address:—L-5-
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ddress:
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Guilder: Permit #: I
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Dater
C -PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE:
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspec,ion I.ine (Rec-O-Phone): 639.4175 Business Phone: 9-4171
Inspection:_��..�
-,
L Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct, Plbg. Top Out Flec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr Insul. Shear Wall Gyp. Bd. -Elect.
Q
Date Requested: Time: AM PM j
Address:
Builder: r_' ; CGc_ Permit
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THE FOLLOWING CORRECTION'S ARE RLOUIRED:
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6100,Inspectors Date:
�--APPROVED DISAPPROVED APPROVED SUB,-ECT TO ABOVE
!Call For Reinsp.
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F TIGARDCITY O
PLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . s MST95-001 h
19126•W H&N Blvd.Tigard,Oregon 97223.6199 (503)639-4171 DATE I 55UE:D c 01/30/95
PARCEL: "wS 1 10DA--RSO?•7 �
SITE ADDRE S. . . : 15421 SW IYIW AMA Pt_
SUPDIVI5ION. . . . : RENAISSANCE SUMMIT ZONING: R-3. 5
BLOC'K. . . . . . . . . . s LOT. . . . . . . . . . . . . :027
CLASS_.C1C='WC)RK. . cNEW...___....,...GARk3AGC�DI£aAOi-iAl.a. ..Y.1_....,...._...._._...__..._.__..._.__..._.......°.............._r.,....._._.._- ,
TYPE OF USE. . . . ..SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . s 1
B OCCUPANCY GRP. . a R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . 10 I
STORIES. . , . . . . cam' WATER HEALERS. . . . . . : 1 CATCH BASINS. . . . . . . 10
F"IXTURES—.- --.-...—..--_.-_._...-._.-- LAUNDRY TRAYS. . . . . . : 1 SF= RAIN DRAINS. . . . . : 1
':')INKS. . . . . . . . . : 1 UREASE TRAPS. . . . . . . :0
L_AvATURIES. . . . . :4 bTHEP FIXTURES. . . . . :0
T.UFi/SHOWEW. . . . : �EWE:R LINE" (ft ) . . . . 10 i
WATER CLOGI�TS. . :3 WATrR LINE (ft ) . . . . a 100 w
UI5I-IWASHERS. . : : : 1 ?AIN DRA,1N (ft) rv. . Ret •.. .�...-
Remarks : L=ATH T
OWNER:
RENAISSANCE: CUSTOM HOMES INC TIF $ 155 0. 00 JF 01/30/95
i
WILI. AMETTtw FALLS DRIVE: 514M $ 180. 00 JF 01/30/95 - !
SWM $ 100. 00 JF 01/30/9n -
j �.Jk WET
I.-INN OR 97068 BPRT $ 725. 50 JF 01/30/95 !
Ohoi)e #c 557—£112'00 B P L C $ 471. 58 JF 01/30/95
BSPC i 36. 28 JF 01/30/95
f lambing Contractor,:-.- �- - - - BARK 500. 00 JF' 01/,°;0/9 t
`Q t_ MPP.T >l 45. 00 JF 01/3 0/93 -
"lame
._:�.tx -; MPLC It 11. 25 JF' 01/30/9 ] i
lddress a_ b �_1.
Lz
. . .._^ _.._ Mbpc $ 2. 25 JF 01/30/95 - I
i�itYs_ . Q� � _States _ 3BTH $ 225. 00 JF 01/30/95 -
� 5
Zips_...__��..�. _. F p a n e#s._�..Sa..�,2._:i�?�a�..�.._ F=51"L 1; 1 1. c,� JF 30/9.�01/
Peg #s,-_ �!-} _ Additional fess not shown here. . . . . . . . . I
--_ - - REOU:I RED INSPECTIONS
---- -
ihis permit is issued subject to the reg -
ulations contained in the Tigard Municipal Footing Insp InsUlation Inar, i
j Code, State offOre. 5p9cialty. Cd'd'bs avid all Foundation I'nsp Gyp Board Insp
otherapplicable laWg' . All work will be done Post/fleam Stv-uct Rain drain Inst
i.ri accordance with .approv d plans. This Past/Beam Mer_han Water Line Insp i
i)erA*rit~will Expire if work is not started Crawl Drain Water ciervice In
�Nithin 160 days of issuance, or if work is Plm/undslab Insp Appr/Sdwlk Insp i
,,uspended for More than 180 days. PL.M/IJnderf1aor Mechanical Final i
Mechanical Insp Plumb Final
Plumb Top Out BUi lding f' incl
Framing Insp Erosion Control
I� FirepPace Insp
t �... '�' '.`. _.._ .- Gas Line Inge _ +____. _._T._ _ '•
fluthorized Plumt.,rng 1- ontr'actor Signmture
Call for inspection - 639•-4175
Contractor N o t e s c
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CITY OF TIGARD
• COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 07223.81 OG (603)839.4171 MASTER PERMIT
PERMIT #. . . . . . . t Mr,T9 -001 ws
is+;3�-4171 DATE ISSUED: 01/30/95 :' k
PARCEL: 2131 10DA--R5027
tn7I TE. ADDRESS. . . : 15421 SW MAZAMA Pi-
SUBDIVISION. . . . :
l_.SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R-•3. 5
13LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :0 7 '*
BUILDING ________.___.____.___ ___._..._.______,-__-_._- ;
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . 10 sf
CLHIBS OF WORK. :NLW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :759 $f
TYPE. OF USE. . . :SF FLOOR AREAS____.__.__._.__. R1-'GTUIRED SETBACKS._..__.-._-____
TYPE, OF CONST. e5N FIRST. . . . : 1439 sf LEFT. . -.20 ft RIGHT. :5 ft
OCCUPANCY GRP. :R:3 SECOND. . . : 1720 s FRONT-20 ft REAR. . :63 ft
STORIES. . . . . . . ..2 FINBSMENT':0 s REQUIRED--------------------
HE 1131-41'. .
_________________._HEIG1-I1'. . . . , . . . 119 ft 'TOTAL•.--_----3'159 sf SMOKE DETECTORS. :Y
F•LfJUR LOAD. . . . 140 ps f VALUE. . . . . : 216610 PARKING SPACES. . : 1
f;emarks : PATH I
PLUMBING -----------------------------------------
SINKS. . . . . . . . . . cl
-__._--_.__-___-_-___ _SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACIAFI_l7W PREVNTRS. . : 1
'
LAVATORIES. . . . . :4 WATER HEA_PERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
WA'f KR CLUSETS. . :3 SEWER LINO (ft) . :0 GREASE. TRAF'S. . . . . . . :0
1)1SHWASHERS. . . . : 1 WATER LINE (ft ) . i100
OTHER FIXTURES. . . . . :0
a GARBAUE: DISPI. . . : 1 RAIN DRAIN (ft) . :0
,
WASH I NG MACH. . . : 1 SERAIN DRAINS. . : :1
MECHANICAL ___.__..__._____.____._._. _..____.____ --- FEES
FUEL. TYPES.________-__ UNIT HTRS. . :0 type- amount by date--- -r.erpt
/GAS/ / 1 VENTS . . . . . :0 TIF $ 1550. 00 JF 01/30/95 -
MAX INPUT:O BTU VENT FANS. . :4 SWIM $ 180. 00 JF 01/?!�/�31ti -
1 TURN ( 100K . . :0 HOODS. . . . . . : 1 SWM $ 100. 00 JF 01/30/95 -
FURN ) 4100K . . : 1 WOOD5IOVES. -O BI-IRT $ 725. 54 JF 01/30/135 -
FLOUR FURN. . . . :0 CLO DRYERS. : I BFILC $ 471. 56 JF 01/30/95
BOIL./CMF' ( 31-1P:0 OTHER UNITS: 1 B5PC: $ 36. 28 JF 01/30/95 -
�_�-� _ GAS OUTLETS: 1 PARK $ 500. 00 JF 01/30/95 --
iMF.IR T $ 45. 00 JF -
RLNH I SSANCE CUSTOM HOMES INC MPLC $ 11. 25 JF 01/30/95 -
? 157 : WILLAMETTE FA1_I._S DRIVE M:iw'C $ d. 2:5 JF 01/:30/135 -
3BTH 225. 00 JF 01/.30/9 ; -
WE_S T LINN OR 97068 P5PC A 11- 25 JF 01/;30/95
Phone #: 557-8000 EROS 88. 00 JF 01 /3121/95
;0/95 -
Contr.aet or: _.____._ _._____ .._.__._......_.__._._...._—__�--ERr'c� $
28. 60 .JC= 01/30/95
RENAISSANCE DLVELOPIME:NT ERPC $ 28. 60 JF 01/30/95 --
1672 SW WILLAMETTE FALLS OR
1
j WEST LINN OR 97066
{ Phone #: 557--800ri)
Rey #. . : 4995 ;
$ 4003. 31 TOTAL _ --•-_-_.
This permit is issued subject to the regulations containeo in the - ------ REQUIRED INSPECTIONS --- -- -
Tigard Municipal Code, State of Ore. Specialty Codes and all other f=ooting Insp Plumb Top Out
applicable laws. All work will be done in accordance with approv±d Foundation Insp F=r-aming Insp t
plans. This permit will expire if work is not started within 180 Post/Beam Struct F`ir-eplace Insp
jdays of issuance, or if work is suspended for more than 160 days, F'ost/Beaam Mechan Gas Liner Insp
Crawl Dr-ain Insulation Insp
► erm.r. CCee 4iiyne7i ..rr rrs >r�-' � ____ M'lm/undslab Insp Gyp Board Insp
r FILM/Underfloor Rain dr-min Insp
Issi.led By.- I+Iechanical Insp Water- Line Insp
Ual 1 f 0r^ inspection 639-4175
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{
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT SE14E:R CONNECTION
13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (603)630.4171 PERM I T
P'F.RMIT #. . . . . . . : SWR95--001.
6313-41.71 DATE ISSUED: 01 /30/95
PARCEL_: c'S110DA-••RS027
1I ' ADDRESS. . . : 154��1 SW MA7.AMA PL
bUBIJ 1 V 16I UN. . . . : RENA I SSANCE SUMMIT ZONING: R-;3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .Q1 7 4
____-___----_-_--_-_-..._.-_--_---_.___
1'ENANI' IVAME. . . . .
USA NU. . . . . . . . . . : F1 X TURF: UN I TS. . .
LI.-A'S'S OF WORK. . . :NEW DWELL I I\JG UN I TS.
f-YPL OF' USE. . . . . :SF NO. OF NUILUINGS: .l
INSTOLL TYPE. . . . :BUGWR IMPERV SURF'ACF. . : : s f
remarks : F',aTE-I 1
ijwner . _.._________.._.._.._____._.___.____._.____________.---._._______._...__ __
- __. FEES ••---_.-___--__.__...... ''
RE_.N(AIGG(INCE CUSTOM HOMES INC type ainc)J..kT1 by date r-eCRt_..__ {T4y1.
167c WILLAMETTE: FALLS DRIVE- PRMT $ 22'9.10. 00 JF 01/30/95 -
1IIr�f- 6 ,. -
WEST LINN OR 970613
Thune
#: 557-8000
Contractor:
L;ONTR(4C1'OR NOT ON FILE
1 'Irane #: t `2135. 00 TOTAL
F1Epq #. .
REQUIRED ?NSPECT I ONS -
This Applicant agrees to comply with ail the rules ano regulations 'aewpl- 1 rrSPect i ar.
of the Unified Sewage Agency. The permit ax ires 180 days froe
the date issued, The total amount paid wili be forfeited if the
oereit 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 prosper` 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer” Permit and the Agency will install�aylateral.
mitt,Qe Si9natt_cr,r:., . � ��..___ ---�� � T` h
recf Ny :
_ ._..�
Call for inspert i cin - 6.39--41'75
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Residential Building Permit Application
1 City of Tigard 7
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
In
7 OittG�Use on
Subdivision: C A;510,41ric"A• s %N•%-Aot #
PlanddReo.#-
Valuation:6*1__
Permit#
Owner: Renaissance Custom Homes, Inc. Reissue of
Address: 1672 Willamette Falls Drive ;
West Linn, OR 97068pgCgVRl3 egUlred � � k
Phone: 557-8000 }>s'
ttglnerir►g .
Fis ESdew} � K '
Contractor: Reniassance Custom Homes, Inc.
Qt or .......
Address: 1.672 Willamette Falls Drive
items s��,ir�d
West Linn, OR 97068
at�bcohtraciors �> �� ••` '''t �
Phone: 557-8000 f ,
Contractor's License # 97599
(attach copy of current Oregon 1/cense) `. „ : Y
Subcontractors:
Plumbing: Cagie Plumbin ! /
Mechanical: Tri-County Temp
(attach copy of current OR Contractor's Lkense)
Architect/Englneer:
Address:
Phone:
COMMENTS:
Applicant Signature R Phone number i
Received by: bate Received: _
I
1
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. .awne�e
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Permit # Account Description Amount Amt. Pd. dal. Due
hlSfrlS-0 CBldg. Permit (BUILD) 1�
i
Plumb. Permit (PLUMB) 7—Z 5.`6
Mech. Permit (MECH) 45",
,
State Tax (TAX) 49,
Bldg:
Plumb: 1 S
j Mech: Z•2 j,
Pi. 1 Check (PLANCK) "L 3 Z Sy :2 37 S93
Bldg: —JZ/,—5 S
PIi:enb:
Mech: /. Z
i
Va/ -,ewer Connection (SWUSA) ��Zv v � 2 -2,v _
Sewer Inspection (SWINSP) _ -3j _
Parks Dev Charge (PKSDC) 5v0
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
rug.'a� '�?M•n;�
GecvaefeW-TFF-- -'(TIF-C)
ktd�sTPlat'I'ti<— - -S' G � G o
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
i
Fire District (FIRE)
TOTALS: (rj. jy 3 I
i
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1
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CITY OF T I GARD - RECE I FST OF PAYMENT RECEIPT NO. A95-261090 1
CHECK AMOUNT x 5988- 31 `
Nf1P1C RENAISSANCE DEVFLOPMENI CASH AMOUNT 0. 00
=�t}I>RE55 o PAYMENT DATE: 01/30/95
SUBDIVISION
I oURPOSC OF PA'r MF NT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID I
Hll I LD I NG �'1=RM
725. 50 PLUMBING PERM 225. 00
IhC:.CHFANICAI_ PE: /4 5. V10 ST. BUILD PER 49. 78 I
L'-''LAN CHECK FE 23i2. 83 SEWER lisp 2200. 00 {'
+SLWEw R INSPECT 35.00 PARKS :SDC 500. 00
1
RESIDENTIAL TRAFFIC.; FEES 14:30. 00 MASS TRANSIT TIF FEES 120. 00
H2O QUALITY FACILITY F"FE" IE10. 04A HRO QUANTITY FACILITY FEES. 100. 00 t
EROSION CONTROL PERMITF EE. 81B.00 EROSIQN CONTROL PLAN CK 28. 641 f
EROSION CONTROL. 28. 60 II
I
MST93--00 t F
15421 SW MAZAMA, LOT 27
TOTAL AMOUNT PAID - - -> 9988. 31
1
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