12560 SW SUMMER CREST DRIVE 12560 SW Summer Crest Drive
MASTER PERMIf
CITY OF TIGARD
PERMIT#: MST2002-00471
DEVELOPMENT SERVICES DATE ISSUED: 12113/02
13125 SW Hall Blvd., Tigard, OR 972.23 (503) 639 4171
SITE ADDRESS: 12560 SW SUMMER CREST DR PARCEL: 1S134CS-05200
SUBDIVISION: ANTON PARK ZONING: R-7
BLOCK: LOT: 014 JURISDICTION: TIG
REMARKS: 224 sq.ft. addition -living and dining room
BUILDING
REISSUE: STORIES: t FLOOR AREAS
REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 224 at BASEMENT: of LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: of GARAGE: of FRONT: PARKING SPACES
TYPE OF CONST: 9I DWELLING UNITS: THRID: of RIGHT: 5
OCCUPANCY GRP: RJ BORM: BATH: TOTAL. 224 of VALUE: 20,697.60 REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: Ft OOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN,100K: BOIL/CMP<2HP: VENT FANS CLOTHES DRYER:
FURN>000K: UNIT HEATERS: ti00DS OTHER UNITS:
MAX INP: htu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 400 amp: 201 400 amp: tai WIO SVCIFOR SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EAADDL BR CIR SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601.ampa•1000v: MINOR LABEL:
1000♦ormallolt: PLAN REVIEW SECTION
Reconnect only: >•4 RES UNITS: SVGFDR»225 A.: >600 V NOMINAL* CLS AREAISPC OCC.
ELECTRII"L•RES1 RICTED ENERGY
A.Sr RESIDENTIAL B.COMMERC,AL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: IN!1TRUMENTATION. MEDICAL OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS TOTAL N SYSTEMS:
TOTAL FEES: $ 588.42
Owner: Contractor: This permit is Subject to the regulations contained in the
LOPEZ, FRANCISCO E +SARAH G AFFORDABLE CUSTOM Tigard Municipal Code.State of OR Specialty Codes and
12560 SW SUMMERCREST DR HOMESBUILDER all other applicable laws All work will be done in
TIGARD,OR 97223 TIMOTHY B BRIZENDINE accordance with approved plans This permit will expire H
7155 SlN 189TH A\/E work is not started within 180 days of issuPnce,or if the
ALOHA OR 97007 work.;,;suspended•.i more than 1P0 Jays ATTENTION
Or%jn low require. .0 to follow rules adopted by the
Phone: Phone: 591 9604 Oregon Utility Notification Center. Those rules are set
forth In OAR 952-001-0010 through 952.001-0080 You
Rap N: 1 I(` 24277 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
fdr90(rri}i4r,48#( Underfloor insulation Electrical Rough In Rain drain Insp
Footing Insp Crawl Drain/Backwater Framing Insp Electrical Final
Foundation Insp Fooling/Foundation Dr; Shear Wall Insp Mechanical Final
Post/Beam Structural Mechanical Insp Exterior Sheathing Insl Final Inspection
Post/Beam Mechanics Electrical Service Insulation Insp
Air
Issue By Permittee Signat0re
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
'$U I►-'�►�I 6 wP ER rv% iT Mt/c A TIS N
P-rmit no.: M ST.2 M)"z -cry471
fico q b p� S o Date Received: EC: Y / N
l
Lk � ),late Issued TP : Y / N
1 &2 family dwelling or accessory Commercial/industrial Multi-family ew construction Demo
,,MAddibon/alteration/rrplacement 1 Tenant improvement C3 Fire sprinkler 0 Other
Job address: _ O S:UI. sin 'PY' - 1461 rd J Bl no.: Suite no
Lot: Block: Subddivissiion_`s-N s„Sr ern Tax map/tax lot: �— _
Oct name: 0 2 1 7 2�
Descri on and location of work on premises/special conditions: 4 dd
Name: u z
Mailin address: Z o S /. %vur,�LvcYvF 1 & 2 family dwelltng:
Cites _ State Zip: 7;15 Valuation of work:............. .........$ Z
Phone: - 7 _ Fax: - y 7- 7 Z 3L No. of bedrooms/baths............... o 0 _
Owner's representative: T $. BY f 2.X-nd i I Total number of finers............ .....
Phone: 5o3-- �I-0241 Fax: s�3..G��•3-625 Existing dwelling area(sq. fl.)......... 5�,�
New dwelling area(sq. fl.) ............
Name: ;� 3 BY i ZQ r�% Garage/ca-port (sal. t:.) ................
Mailing add, S.W W. I p�, Covered porch area(sq. ft.) .. .
_ k s: 71 5 5 P9 t e. Deck area(sq. R.) �-
City: I,o�u te: Olt- =Zip: q-7 o a7 Other structure area(sq. fl.) ......... v �—
Phone. 3r> 4Sl 02-4 Fax: c,3-- 6 3-CCommerciaVIndastriaVMuld Family:
Valuation of work: ..................... _
Business name:T,t„ dl- f ffoq&6I& tvs ,bru6,-, Existing bldg. area(sq. R.) ...........
Address: 71 SV�-�9?� Va ..................
�I . New bldg. area(sq, R.) --
Cit State p Zip7vo Number of stories ........................�—
Phone: 3 o 3 6 u 4 Fax: 03- y5+1. Type of Construction ...................
- 541.-
CCB no.: Q,.,2,/+Z77 __ Occupancy Type ..............Existing:
Local City oMetro lic. no.:ooO0 33 .0 _— New:
r _ -
Notice: All contractors and subcontractor are required to be
Name: "r" •- 6Q C licensed with the Oregon Construction Contractors Koard raider
��--B. provisions of ORS 701 and may be required to be licensed in the
Addrest;<: $� _ jurisdiction where wo.k is being perfo ied. if the applicant is
Cites— a u State: O R Zip: 7 o c7 7 exernpi' .nn licensing,the following reason applies,
Confer:person: i r►. _f}1frI'Z10- i ---- ----_- _ __.__ ____
�rittme: o' $)' o24Fax v 'GZS
Name: r Contact person. Pay A.1 Building Fee: �y
Address: T)MPPlan Check Fee ___-.---_.----
Cit _ State: — Zi State Surcharge: -- - _----_----._-�
Phone• Fax Total:
S`L z jus- G y 3- 2 I�8 Amt. Paid:
1'iereby certify I have road and examined this applicabion and the attwho3 wor* rhocklist. All provisions of laws and ordinances governing this work will
complied with,whether ed hereinQ ort�t-
uihorized signadrr¢: �_f _—
rint name: i h ._._ ____M_ __ Date:J, _
Yorke. This pe►nrit appUcadon expires if a permit it nor obtained within 180 dep after it has been accepted at cow#ete.
2002 6, 1 C'
Electrical Permit Application
Date Rem'ved: FC: MaT)Em) Y N
7
Date issued: 1�'. (NEEDED) Y N
—1 &2 f%Tv*dwelling or accessory C.onarterctaVindusirial Multi-family I errant improvement
construction y AdditionJaltennon/replacemcrit Other -(if underground utility, may be subject to
o.-miiari control and/or tree vrotection)
Job wktreas- Bldg.no.: suite no.:
Tax"Mq)Jt&X lot: Project nem:
City:
ZIP: Tenant:
Deocripfievi of work:(tic Ispedfic) 0(A t -(-JAL
Job No: Deseriptlinn Qty I Fee Tool Imp
Buninem name: J iw% Elf rAy I SM New reW-.ntIzWo1Ie or muld-fitadly T
Addresit: per dwdft unit.Includes attached
prope.Service Included:
a#%S ion State: UK I ZiPI-7111 1000stIftorless CNewCeust.Only) 1 106-00 4
Pbne: Fax: I--,- Each additional 50*ft or portion thereof 20.00
cm# Bloc Bus.Lic 0: 3 4-'7 4 r— Conned energy,Now Residential Only 40.00 2
q"Mo Lic.# Limited energy,New Commercial Only 40.00
Each nutnulbetured ham or Modular
-swcure of X&VWrVt#M9 elecmciant(riquRd) Me dwell service and/or feeder 30.00 2
Services or feeders-Installation,
is alteration or relocation:
SM.
Bleat.Nam taint) uomo NX)orrips or Ines 63.00 2
201 amps to 400 amps 75.00 2
401 arms to 600 anon I 25.00
Name: )'ca L 2-
Address: 12,56 �;'W. M 5'_'r."e cv e 5-+ 601 amps to 1000 arrips 163-00 2
Cq: -f- wa I State: b L I zlp-.qliz " 1000 amps or votes 375.00 2
Phone: 3'd;-7U q- Reconnect on!Y. 50.00 1
Owner Jjvt-,,dkrtjon JU installefion to being nwWC on PnMcftv I Own Temporary services or feeders-
which is not intended for ode,lease,rent,or exchange according to ORS installation,afteraftoo or relocation:
447,455,479.670,70 1. 200 unpa or leas __ __ 1 50.00 2
Owner',, Sirn. Date:— 201 amps to 400 amps 69.00 2
401 amps to 600 antes 100.00 1
Nam: 1 ranch drevits-now,alterstlen,or
Addmq;: extension per panel:
A fee for branch circuits WM ournhwe of
City: stm; Service or feeder fee,arch circuit: 5.00 2
Fax: 4ZBrawh circuits-new,alteration,or
ermwift per panel:
_Service over 225 amps- Health r re fkcilny B fee fur branch circuits wilhoW purchase
com"Mcial — of Service or feeder%a,first circuit: 4300 2
—Service ever 320 anip-rating _Hozardous location Each additional branch circuit: 5.00
of 1&2 f1mily dwellina Building o%-.t I 0,0M sq ft/ Mine.(Service or feeder not Included:)
5ystorn over 600 volts Each EUM or!071circle 50.00 2
nominal four or rnore residential 109 -
units in one structure Each sip or outline lighting: 50.00 2
Building over three stories Feeders,400ii—Mor.noi Signal circuit or liftled energy panel,
occupant kad oveT 99 Manufk-uped structure or RV alteration,at extension, 50.00 2
0 Description_
Lack additional loop.over the aftorable I
Mar Additional inspections: 42.00
Flow subunit(2)seta of PIMUS with ANY Of tie alierve.
The abs it are am epplicablie to tonWoriary evert.service Investigation Fee 1 69,00
TOTAL:....................................... S
PLEASE CONTACT"t'll-DING SERVICES FOR Plan Review Fee(1freitlidired) (25%)....
CREW CARD JNMRMA'nON State surcharge: (9%)........................ -
1/21/02 TOTAL:
Mechanical Permit Application
Date received: Pet[lilt no
City of Tigard Projecl/appl.no.: Expire date:
CiryofTigard Addre9s: 13125 SW[fall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 bate issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval _ Building permit no.:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction 'W Addition/alteration/replacement U Other: - J
JOB AlITEINFOIRMAUVOMMERULM,
Job address: Z J urm Nuc v' <_y r`> Indicate cquliimcut quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: profit. Value$
I.ot: Block: Subdivision: 'See checklist for important application information and
_Project name: L o VLk Z iurkdi(tion's fee scheduie for residential Kermit fee.
City/county: r. tfv s ZIP: _
Description and I cation of work on premises:.- h " INOMA 10 1 AI I Wk I I NON I d
'Vf — l Irt•Ic:r.i fnrai
Est.dal;of completion inspection: DewriptionIty.nuh tte".onh
Tenan.improvement or change of use: '
Is existing space heated or conditioned?U Yes U No All handling unit CFM
Air conditioning(site p an require )
Is existing space insulated?U Yes U No A tcration of existing I AC system
St,ToT.er/compressors
State boiler permit no.:
Business name;
c,r! 6 �,� Lv 5 t W s' NP Tons BTU/N
Address: '7 I rs' S AAL dy F- Fire/smoke damper:/duct smoke defectors
City: t StateHeat pump(site plan require )
Phone: f - u2JF Fax" 6Z mail: N.- nsta rep accfumace/ urner 1
l CB no.: g.J��.��y i _ Including ductwork vent liner ❑Yes d No
_ nsur rep ace/relocate heaters-suspended,
City/metro lic.no.: --� wall,or floor mounted
Name(please print): u+v em for a lance of er than furnace
1Refrigeration:
NTACY PERSON Absorption units_ --_- BTU/14
I Chillers- - -- III'
Name: rCompressors III'
Address_ .Vronenta
exhaust and ventilation:
City: F11Aq Slate: p ZIP: 7007 Appliance vent
Phonc:''µ$ I Fax:" -613 f I E-mail: ).rycrex aunt _
no s,Type / res. itc ie nzmat
hood fire suppression system —
Name: yah c d S r r. ` v Z- Exhaust fan with single duct(bath fans)
Mailing address: LS-1, YCr� Exhaust system apart from heating or AC
City: q _ State: ZIP: '!2L "U",piping andistribution(up to out clad
Type: __LI'C; NO nil
Phone:' hax:l'7 -7Z 3 1's-mai1+� vc i ttn cac 1—additional over w out els
1111&111110 10roces%piping(se ematicrequire )
Number of outlets
Name:
_—_--- Other lWed appliance or equipment:
Address: hecorativefireplacc
City: State: ZIP:_ nwrl type
Phone: Fax: E-trail: Woodslovelpellet stove
Other.
Applicant's signature: ���, ?1e /-� -`n ter.
Name (print): t l _ _-
Nin at!jurisdictions acepi credit cards.please call hrrisdictim for Hume infammicm. MiniPermit fee fee
................$
C]visa ❑MasletCard Notice:This permit npplicatinn Minimum fee....... . ......$
expires if a permit is not obtained Plan review(at __ %) $ _
Credit card number spires within ISO days off-t it has been -
Name of cardhot r as shown on sirs card — accepted as complete. Stale surcharge(89h)....$
cardhoider slgnatrae----- Amount 440-4617(6WK'0M)
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CITY OF TIGARD 24-Hour
BUILDING Inspection " .ne: (503)639-4175
MST
INSPECTION DIVISION �',lori^ Busine•ss Lile: (503)639-4171
BLIP
I, ,Li`{
`
Received - Date Requested AM -_ PM__—_ _ BUP
Location _ �SLy ����t�t �L�d Suite—� _ MEC
Contact Person Ph(—I dd- I PLM- —
Contractor -- -- - -- Ph( ) — SWR - -
ILDINa Tenant/Owner _ I_LC
ling ----- E-LC --
Foundation ACC@ ss-
� n � / U
Ftg Drain /� I' ((J � l ✓� L•�� hLR ___— __..
Crawl Drain - --
Slab Inspection Notes: SIT
Post&Beam --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - ------ --- - -- - -
Fire Alarm
Susp'd Ceiling
t4'
Roof - --
Other:
FIr�
ASl3 PART FAIL
PL _81NG_ - - - -
Post& Beam --- -
Under Slab -
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhola
Storm Drain - ----- --- Y--_
Shower Pan
Other: ---- -
Final —
T FAIL
NI --_-
o eam
Rough-In ----—_ ----- -- - - - --- -----
Gas Line
Smoke Dampers
R
A� PANT FAILE TTRICAL
Service
Rough-In ------------ - ---- -- —
UG/Slab
Low Voltage ----- ------- - �—
Fire Alarm
Final
PASS PART FAIL u Reinspection fee of required before next inspection. Pay at CityHall, 13125 SW Hall Blvd.
SITE — [] Please call for reinspection RE: [] Unable to inspect-no access
Fire Supply Line
"< <
Approach/sidewalk ADA Date 2 // //v ,- Inspector _ ��� Ext
Other: _-_ --_---_.
Final DO NOT REMOVE thif Inspection record from the Job sits.
PASS PART FAIL
CITU' OF TIGARD 24-Hour
^UILDING Inspection Line: (503)639-4175 —��� C -7
MST
INSP ,TION DIVISION Business Line: (503)639-4171
_ BLIP _Received -------. Date_._______-_. ---____. Date Requested S _ __ AM__—_— ___ PM ___ BUP
Location -- / 3 �_�_--� -t��C ?YLCYY �� Suite -- ��- --- MEC -- -
Contact Person — --__._—�w�1G4�" - --- Ph( ) ��_
PLM ---- - - -
Contractor SWR
BUILDING Tenant/Owner - _ ---_-_-_ ---_-._-- ELC -
Footing ELC
Foundation Access:
Ftq Drain ELR —
Crawl Drain __._.—__ —
SIT
Slab inspection Notes.
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Framing l�—�-- ---�-_
Insulation
Drywall Nailing
Firewall
Fire Sprinkler — - -
Fire Alarm V - �
Susp'd Ceiling 1"—
Roof
Other:--_--_ 11 -- — ---
FinalPASS
G (� `
PLUM_BINGRT FAiI — ) — �� �u-`a-�►—. L- � � 1�'�' ��.`� r � L•
Post&Beam
Under Slab _-- -- ---- —
Rough-In
Water Service —
Sanitary Sewer
Rain Drains ------- - — --
Catch Basin/Manhole
Storm Drain ----'—�
Shower Pan
Other: — -�— —
Final
PASS PART_ FAIL_
MEC_HA_NICAL — - - --
Post& Bearn
Rough-In - —�
Gas Line
Smoke Dampers - --
Final
PASS PART FAIL - -- - - - - --
ELECTRICAL _
Service
Rough-In
UG/Sleb
Low Voltage -- -— -- - _ _--
Fire Alarm
Reinspection fee of$ —_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
�PASS. PART FAIL
_.
g � Please call for reinspection RE:_- -____ ,__ Unable to inspect-no accE ss
Fire Supply 1.ine
ADA
Approach/F;idewalk Date `S �� Inspe =�.,-_.-_- _-- .- Ext
Other:
Final DO NOT REMOVE this Inspection record from. the job site.
PASS FART FAIL