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10651 SW LADY MARION DRIVE s_. w LLLE N 89'53'03" E 65.00' FwLE 40L 402 �" oft- 0% QOIPIIIIIIIIIIIIIIIIIllmw)(Zq Ch0 3q � o � *3 to 0 ZN C4 �- 0 0 V) 21,50' 1O 10.50'c ` i W � 7.00' ' erg 3q ! N i i O o L----- pi 4- Z twal i i i i i 5.0' 6.00' 8 22.00' 12.00' 11 92' 9.1 r 292 49 d c O N co O < N > N SF--Wf*-- R-`4 75. 00' L=6 5 . 41 ' 306 V S. W., LADY MA SCALE 1" = 20' RS oN DRIvF SCALE DRAWING LOT 40 ERI CKSON HEIGHTS S.E. 1 4 SEC. 10, T.2S., R.1 W., W.M. 1461 SW L " 4� M X4D --- FLIP HOUSE, 2/23/01 M::,C,. CITY OF 71GARD REVISED SCALE DRAWING, 2/22/01 MSG. WASHINGTON COUNTY, OREGON 'y A 2.5' LANDSCAPE EASEMENT SHALL EXIST ALONG ALL STREET FRONTAGE AND A 7.5 PUBLIC UTILITY -- MAKE ::CALF DRAWING Irq-rc, STAKEOUT, AUGUST 2, 2000 Centerline Concepts Inc . EASEMENT SHALL BE HING THE LANDSCAPE EASEMENT. MPW, 9-6-00 DRAWN BY: MSG CHECKED BY: WGDIII MOVE HOUSE BACK TILL i_EFT SIDE 'S 20' SCALE 1 "-20' ACCOUNT # 115 FROM FRONT PER TRAVIS, 8/7/00 MSG. 640 82nd Drive Gladstone, Oregon 97027 M: \MLI\L40ERICK 503 650-0188 fax :503 650-0189 F ,,...,, _._. .......,,,,�.�.. NOTICE: IF THE PRINT OR TYPE ON ANY � I I 1 IMAGE IS NOT AS CLEAR AS THIS NOTICE, 9 1� I 1 ` I2 r �y dads IT IS DUE TO THE QUALITY OF THE _ No.38 ;x,, ORIGINAL DOCUMENT IIgIIiIIIIII�ILI llT liil$ I . IIIL IT 11II9 TII 63 89 14 I� I�IIIIIIIII11llll �ll1.1 �1lull . 11I T 11713 T li1 T illl6 Ill111111 I-'llu1 WL 1111411 1 0 rn N CL 3 0 4 10651 SW Lady Marion Drive CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00358 DATE ISSUED: 08/15/2001 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 PARCEL: 2S 110DA-07900 SITE ADDRESS: 10651 SW LADY MARION DR SU601VISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 040 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSET. WATER LINE: ft DISHWASHERS: RAIN DRAIN. ft Remarks: Irrigation backflow prevention device. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 27200100000 1672 SW WILLAMETTE FALLS DR 5PCT CTR 08/15/2001 $2.90 27200100000 WEST LINN, OR 97068 — – Total $39.15 Phone '. 503-557-8000 Contractor: MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 503-630-5532. Final Inspection Reg#: LIC .5973 PLM 11717 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit,vill expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 dEys. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application rDatereceived: Permit no.:f';M^ODI City of TigardSewer permit no: Buiit:utg permit no.: �I Address; 13125 SWHall Blvd,"Tigard,OR 57223 pro ectl 1 no. _._. F.xpiredate: Ciry of Tigard Phone: (503) 639-4171 app Pax: (503; 598-1960 Date issued: p,/? Receipt no.: Land use approval: Case file no.: Payment type. __.�. I O &2 family dwelling or accessory O Commercial/industrial O Multi-family O Tenant improvement l ew construction D Addiuonlalieration/replacement O Food service >Other: I Deacri don Flea.) I Total Jl�� 5 !_ S • ��r� c_1�[! ew l-and 2 tarn y we gs o y: Job address: � Bldg. no: _ (includes loo ft.for each utilltyrnnnectlots) — Tax map/tax lot/account no. _ SFR'1)bath Lot l �7 rBlock: rSubdivision: SSR(T)Each Project name. /t/ .Sc•v e+G (3)bath L ac addition a Cit /count schen } IP' 2-�—'-�'`'�'`� Silo utilklartr � i DescripUun and location of work on premises Catch basin/area drain ' t/leacht� nodi drain Est.slate of compleuun/inspeclion oottn�min(no. lin. ft.) anu soured home utilities Business n3rTIC: 'I C , ti 1 /i��1 J! ' �� r Q CS — --- Address: Rain Irr n connector JX f State(� ZIP: `?7 __ ani ary newer(no. lin.ft.) city: FYI.: r�rcr Stotm sewer(no.lm. I. Phone: cf �v f-' 2- Fax �.+,c E-mail ---- Water service(no, lin.ft.) - - - _ - CC$no: Ili / Plumb bus.reg. no: r`f'7 3 ,_.-- Flxtu.e or item: city/metro lic.no. -T--- Abso tion valve Conu-actor's re signal ; �/.- ac ow rt>venter —_ ,N Dater- a-mater v ve Print name /, .. r' .r —_ �.� - IN Basins/lays!ory _ l Clothes w-Zer v Name: ,. C 1 o!6 - Dishwasf,er Address: c' ?i�� r- - D�tin tin ;fountatN(s) City: -y Stated Phone:fc,7-C.j'c 4 E-mail Expansion tank ---__-rt—� Flxmre/sewer ca oor draius/fIuof sinks/hub Name( rint): ._ Garbs a dis sal Mailing address: j/ Hose bibb City: ' State: 'LIF: Ice maker Phone. Fax. E-mail nterce tor/greme trap Owner install etic n/residen6al maintenance only: The actual installation n'rner(� �__—_ --}---- will be made by me v e nteriance and repair made by my regular Roof drain(commercial) emplovee on the p est 1 w as per ORS C pter 447. i ' r' tnk(s), astn(s),lays(sj 7 � 1 I owner's si nature: Date: umTubs/s oweNshower pan Urinal _ Name: — --- Water closet -- Address. _ Water heater City: !_ - $gate i O e't �- _ ----- - - — - — photlr• Fax. �E-ma111: � Total - I -----�-- Minimum fee......... ...... Nd•11 Jw{�d,ctiun+xturr uatlt elide pleux can juHWicdon ra tome, -I—dost Notice.This permit applicat'on Plan rrview(at ') $ .. U Vie• �1 Maat�C srd cxpires if a permit is not obtained State surcharge(9%) •••.$ ._ �� Cmdlt cad numte: aplrc� within ISO days after it has been $ _ accepted as complete. Name of cardholder r shown on nadd card S Csrdholda ti4nuun — Amount aawr le(r>ocvf0�t MASTER PERMIT OFTIGARD PERMIT PERMIT #: MST2001-00113 DEVELOPMENT SERVICES DATE ISSUED: 3/27/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10651 SW LADY MARION DR PARCEL: 2S110DA-07900 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 040 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 21 FIRST: 1,646 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.241 of GARAGE: 711 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: or VALUE: E 266.528.00 RIGHT: 5 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: .'.EBT 00 of REAR: 60 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: 7UB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<t00K: BOIL/CMP<3HP. VENT FANS: 5 CLOTHES DRYER: '. (;AS FURN>-100K: I UNIT HEATERS' HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS, 1 WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS_ ADD 'L INSPECTIONS 1000 5F OR LESS 1 0 200 amp0 200 amp' WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION- EA ADD'L SOOSF: 5 201 400 amp: 201 400 amp: lot W/O SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR'. LIMITED ENERGY: 401 - 800 amp: 401 800 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FOR. 801 • 1000 amp: 601.ampo•1000v: MINOR LABEL: 10004 amplvolt: PLAN REVIEW SECTION Reconnect only: -4 HES UNITS: SVCIFDR-225 0.: >600 V NOMINAL: CLS AREA/SPC OCC. ELECTRICAL•RESrgICTED ENERGY B.COMMERCIAL A.SF RESIDENTIAL '— AUDIO 8 STEREO: Y. VACUUM SYSTEM: x AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: Al I ENCOMn BOILER: HVAC. LANDSCAPEARRIG: PROTECTIVE SIGNI. GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS. TOTAL FEES: $ 7,003.25 Owner: Contrarlor: This permit is subject to the regulations contained in the f:ENAISSANCE CUSTOM TOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Core,State of OR Specialty Codes and 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work wili be done in WEST LINN OR 97068 WEST LINN,OR 97068 accordar„e with approved clans This permit will expire if work is not started within 160 days of issuance,or if the work is stv pended for more than 180 days. ATTENTION Penne, Phone. Oregon lave requires you to follow rues adoptr;d by the Oregon Utility Notification Center Those noes are set Rag N LIC 049951, forth in OAR 952-001-00101hrough 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Ernsion Control Insp 8, PosUBearn Mechanica Electrical Service Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Electrical Rough In Insulation Insp Mechanical Final Footing Insp Footing/Foundation Dr; Framing Insp Rain drain Insp Plumb Final Foundation Insp Mechanical Insp Exterior Sheathing Insl Water Line Insp Final inspection Post/Beam Structural Plumh Top Out Low Voltage Appr/Sdwlk Insp Bui!ding Final Issued By : ILL' E ii _ PRrmittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00064 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-A171 DATE ISSUED: 3/27/01 SITE ADDRESS; 10651 SW LADY MARION DR PARCEL: 2S110DA-07900 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 040 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: JEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SJRFACE: Remarks: Sewer connection permit for new single family detached residence. Owner: FEES RENAISSANCE CUSTOM HOMES Type, By Date Amount Receipt 1672 SW WILLAMETTE ,'ALLS DR WEST LINN, OR 97068 PRMT CTR 3/27/01 $2,300.00 27200100000 INSP CTR 3/27/01 $35.00 27200100000 Phone: 503-557-8000 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be for`eited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer' 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 77x4 31U -01 /z7 u��dloo/-oOOlof/ Building Permit Application City of Z'igard. --- Datereceived: AW01 Pt:ruitno.: C'iryuJftKarJ Address: 13125 5W Hall Blvd,Tigard,OR 91223 Piojcct/appl.no.: L•'xpiredute. Phone:hone: (503) 639-41'71 Dale issued: By: Rtceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - l&2 family:Simple Complex: I &2 family dwelling or accessory U CummeiciaUindustrial U Multi-family )<New construction O Demolition U Additiotdalicr:itiult/replacement U Tenant iniproventent C]Fire sprinklerhilarm U Other: - 1 ' SITE INFORMATION ,til)addltas:.: OV51 SW LADY MAR ,p Bldg,no.: Suite no.: l.ut: 4 on: E�(,�. � Tax ntup/tux lot/account no.: 51-igh- O� Project name: ----- i �(!_d,e, r Dc,cription and location of work on premises/special conditions:__ --- 1,T Name: Mailing address: Loril,(_�j Q� 1 &2 fatally dwelling: , Cit State: 7_IP: .��.� l y' �' - - ^l� - Valuaru^(of work...... .... '�/....~.. ..'..'.. i. Phone: Fay E-mail: No.of tiedcuoms/baths................................. Owner's representative: ') -1 - Total number of floors................................. New dwelling area(sq. ft.) ... Garage/carport area(sq. ft.) ........................ I_ _ Name: � Covered porch area(sq.ft.) ......................... Mailing address fi Deck area(sq.ft.) ........................................ City. State: ZIP: Other structure arra(sq. ft.)......................... 7 Phone Fax: F.-mail - Coulnterciallindustrialiniultl-renally: CONTRACFOR Valuation of work........................................ $ -- Busiue.ss mune: Existing bldg.area(sq.ft.) ...... ........ ......... New bldg.area(sq.ft.) ................ ............. --- Address: ------ _ Number of stories.................... ................ -- City: State: ZIP: Type of construction............ Phone: Fax: E-mail: ....... ............. CCB no.: - - - --- - --- Occupancy group(s): isting: - -- --- New:hr ht) ' Notice:All contractors and subcontractors the required to be ARCHITECIUl f licensed with the Oregon Construction Contractors Board under ANunte; '(,� .71M provisions of ORS 701 and may be required to be licensed in the ��,�--�— jurisdiction where work is beim performed. if thea applicant is Address. LQ � _ J g Pe PP'. exempt from licensing,the following reason applies: Contact person: Plan no.: - --- --6,7-4-- --J-L- 1'.t, 4, -'144 s�� www,poko -- ; EMO Nantr G-bA lCuntact person. R Fees due upon application ...........................$ Address ;L Date received: City: 0�'1iND- _State: Z1P: q 'jaQ Amount received ................ ............... $__ _ Phune: t- P E-mail: _ Please refer to fee schedule. 1 hereby certify I have read and examined this application and the Not all jurudictio u rrrlu cruel ewda,pleaw call jun"ciiun for inure inlot uation. attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will be compiled wdAl whether specified herein or nol. t:tedtt cmd number: __ _ 11__ v' —@xplre� Al1thU1'IZed 51 plllre; l ' - - - - Date: 3 �_ Nante tit i4idlwl r u shown on —ici ii c�T--� Print name: T — "Cwdholder dgnrrwc $ Amount Nutice:•Cois permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613(MU UM) Electrical Permit Application Dotrreceived: //(/ Pernlitno.: City of Tigard Projet:Uuppl.uo•: Expitedute: 4'iry�J7'�burd Address: 13125 SW lia11131vd,Tigard,OR 9722_t -- Phone: (503) 639-4171 Dole issued; By: Receipt nu.: Fax: (503) 598.1960 Case file no.: Payment type: —� Land Use approval: — TVPE OF PERMIT 1 &2 funnily dwelling or accessory ❑Cominercial/industri:d U Multi-fandly U Tenant improvement kIrw coll9truction ❑Addition/alicrutiort/repl:lccmrnt U 0111(.1 U I'urtial JOR WE INFORMATION Job address: ` 4�W �� aPill,-- no•: Suite no.: _ Tax trop/t x luUuccclunt no.: Lott lintel,:V Subdivisiun: -i'101W mute: Descriptiun and locution of work on premises; I nnatrd darn"if romplrlion/i:tsprc•tiiln: 1 1 ' 1SCHEDULE Job Uu: Fee Ntrt Businesb namc. AA J ipliull (11), (ea.) lu1.rl IIU.Iib I Address: p -iJC� - Newresideuriul-sulglcuruwhi-fawilyLrr - dweill a!writ.Includes Attached garage. City: L Slate:QK, 711': ''Q1,' Servicelucluded: Pit one: •�•f2,� Fux •VP --mail: 100094.It.Of less L'.L'$ IIU.: 0 Elec.bus,i1C, o:nl/jyG� Each uddiuuna)SOU sq.n.or gonion dtrreoF Liulited energy,residential Z City/metro tic.no.: Lintiled caergy,non-residential _ Eachrnanufacturrd buine or modular dvrolling Signature of Supervising electrician(required) _ Date Service and/or feeder Sup.eleo nanle(printlL.icensenu: Servlersurferdere-ilutnlluthln, alteration or relocation: 200 amps or less 2 Name(print): 2()1 amps to 400 amps -- iniailin401 Limps to K address• L w v e5 p 6OUartlps 2 --Y = 6U1 amps to 1000 traps 2 City: w State: , Zll': - - — 0 Over 1000 amps or volts 2 Phut FaReconnect only 1 Owner im tal lation:'Che installation is being made on property 1 own 7en putury services or feeders- which is not Intended lb sale,tertse,rent,or exchange according to Illstallatlull,aheratlou,orIelocaIlull: URS 447,4')5,479,6 1. 200 amps or less 2 31s r0) 2n1 am sto4UUamp s 2 ri' ,i ionone' �-'-1 Club: _ 7l 401 to600am s — - _ Brunch circuits-new,alteration, Name: C.6 A or exteaslou per panel Address: 3'l A. Fre for brlulch circuits with purchase of _ service or feeder fee,cacti branch circuit 2 C1lY: p _ State d Z1P: �Z 2, B. Fee for branch circuits without purchase Phone ' �! I':+ � E of service or feeder fir,tUst brunch clrculr. 2 Each additional branch ci1Ulit:EVIEW(Please check all that a 7— -" Misc.(Service or feeder not Included): U Service over 225 utupa-cuuuaercial U Health-care raciliiy Each pump or irrigation circle , U Service over 320 amps toting of 1&2 U Hazardous Iocatiml Each sign or oudinc lighting fondly dwellings U Building over 10,000 square feel four or Signal circuit(e)or a limited energy nanrl, U System over 6(IU vola nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,400 amps or more U Occupant load over 99 persons O Manufactured structures or RV park Uch ad titin __—__ -__-, U Egless/lighling plan O Other. Foch additional inspection neer the allowable In arty of thq above: Submit—sets of plans with an of the above Investigation fee Per ins ecttun The above are not applicable to te►uporary construction service. odler -- Nur all jun"couos&,ell'credo cardt,please call jurisdiction for niont inform nlon Notice:1'his pennit application Permit fee.....................$ _ U Visa U MustelCwd expires if a permit is not obtained Plan review(at _ 'Yo) $ -_ T Credo cold nuinbet within 180 days after it has been State surcharge(8%) $ , spires .... -------- Nume of cardholder as shown uo credit card accepted its complete. TOTAL .......................$ Caidhuldel SIsill 44114611(ti/(16YCOM) Plumbing.Permit Application City of Tigard f�atereceivcd: G / Permit Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer periniino.: building Pei nlitIto.: — Cityq'Fi,wrd Phone: (503) 639-4171 Project/appl.na.; _ Expiredate: Fax: (503) 598.1960 Date issued: -� BY Receipt no.: Lund uSe approval: --- Case file no.: Payment type: --- TYPE 1 I &2 family dwelling or accessary O Conunerciul/industrial U Multi-fancily U Tenant iniprovement New constru,U,1u ❑ Ad�liticw/all�ralitachr�hla �nu'ni U food servic, Othe-: t Job address: SIM LA�-�ILI . _M�_ Descri Mull r Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1-and 2-fanuly dwellings only: �- - -- (includt%100 It.for n:hutilitycowiectiuu) Tax map/tax I itlat:count no.: SCR(I)bath 1.01: AA Block: --------- Project name: EJJ1_11_ SFR(3)bath -- City/county: IrLZA.AnLp _— ZIP; AJLZ1�__ Each additional bath/kitchen Descripuon arcd location of work on prernkes: Sheutillties: CONS•(l LX_�slN_f�t�F1bf7(,�� - �E Catch basin/area drain 1 sr.date of curnpletiotvimpection: - Drywells/leach line/trench drain PLUMBING1 1 Footing drain(no.lin.ft.) ��I��p� Manufactured home utilities Business name: —a i' r4.1 ' '1�_ Manholes Address illb j -�w �, ( _ Rain drain connector City: BEAVE State:- ZIP: qI ah& Sanitary sewer(no.lin.ft.) Phone: I ax E-mail: Stornn sewer(no.lin.ft.) - CCB no.: Plumb.bus. reg. no: LO"14to f b Water service(no.lin,ft.) -- City/metro lie.nu.: - _ Fixture or item: Contractor's representative signature: -_--- Absorption valve Print mance: -- — Back flow preventer �� '� �Tt cal" Backwater valve CONTACT _0 Basins/lavatory — — Name: FE— F,ILI4- Clothes washer Address: ----- -- -�- Dishwasher C.it - -- —_- Drinking ng - Y State: ZIP: Ejectors/sump Phone: -- l a� F-mail: Expansion tank — t Fixture/sewer cap Name(print): 12 ENAV,5z7ALFr Floor drains/1'.'lor sinks/hub -_'- a a dis o Mailing addres�s:��•1Z, '�lw � pe Garb_g p Sal Ctitac: a Hose bibbY lNN - - Ice maker Phone. Fs ?KL E-mail: - Interceptor/grease trap Owner inslallatiun/residential maintenance only: The actual insu elation Primer(s) will be made by me or the maintenance and repair mad, t,y my regular Roof drain(commercial) employee on the proy I own as per ORS Chapter 447. b Sink(s),basin(s),lays(s) Owner'snate: si)matuie ;y Sum Tubs/shower/shower pan —` Nanic <<,�P1 Urinal - — .__----- Water closer - C Water heater City:.. .',NrpJ� -- State: Z11': ZQ Other: - Phon Fa E-mail• 'Total Not all jurisdictions m--pt cra!a aids,please can jurisdiction rue mute inronruuion. Minimum fee................$ G Visa U himterCard Notice:1'Icis pennit application Credit cud numtrer: -- expires if a pennit is not obtained Plan review(at _ %) $ —`. — / / — within 180 ctny9 Stole surchara 8%after it has been S (' ) ••••$ ---- None of cardholder u shown on crulit cud accepted as conlplefe. TOTAL ....................... ^-- CmJhulJer siyti�iure Amount 440 4616(bAX1/C ONI) Mechanical Permit Application �_--�---- Date received:J Q Q// I Permit no.:}',�%�a-GY City Of Tigard Project/appl.no.: Expiredute: Address; 13125 SW Hall blvd,Tigard,OR 9712_t --- - - C'iry�J'1'igurd Date issued: By: Receipt no.: Phone: (5U3) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type Land use approval: Building permit no.: TYPE OF PERMIT 41 &2 family dwelling or accessory U Connnercial/industrial U Mufti-family U Tenant improvement *KNew c,m5trurtion U Addition/alteration/replacement V Clther: JOB SITE INFORMATION Job address: Q(/51 Sw �_�fi4 �a. tu Indicate equipment quarttes in boxes below.indicate the dollar Bldg.no.: _ Scute no: value of ull mechanical materials,equipment,labor,overhead, Tux inup/tax loU-' count no.: profit.Value$ Lot: Block: Subdivisiun: N 14 ''See checklist fur important application information and Project Mune: jurisdiction's fee schedule for residential permit fee. Z1P: - "� 7VFA--C--- city/cuunty: Description and location of work on prenuses: I t 1 M,t Di 11 it P:4 Est.date ofcompletion inspection: Ucscriptiou city. ltes.uttll' R'es.uuly Tenant improvement or change of use; h is existing space heated or conditioned?U Yes U No Air conditioning unit —__ _CFM_,Is�:xistiny space insulated`)U Yes U No Air rationionexisti g HVplatry yst Alteration o�existingTVA(:system MECIIANICAL CONTRACfOR 13olle-r7compressors Business name p1�' ` State baiter pet ndt no.: rLl�i - --Ellei]�N�----------._ HP -_-___Tons BTU/H Address: Fire/smoke dumpersJduct stno_- adetectors City; 1Wito 41LIL6Stat, 00, 1'LIP: eat pump(s to plan regTedj Phan &A• V2A2, I Fax: L-snail: nstall/repluce furnace/burner ! CCB uo• 0�'� Including duetworkivent liner U Yes O No _ ___ --__ _________ nstal/replut relucateheaters-suspended, t'u y/metro tic.11'' wall,or fluor mounted fJ,ni, l plruse l Vent for u lianeeoLherthanfurnace r 1 1 ltefrigerat on: Ahsorpuonunits� _ BTU/l- Nwnc: Q,E; Chillers__— . _--_ HP Gl-- -1 Address: - - --— --- Cont ressots_--------- IIP -- Environinenta exhaust and vendhttiun: City: r State. ZIP: Appliance vent — I'll, "!„ nr Fax E mail ryerex uu!n _ 1 Hoods,Type res. tc en/hazmai `1A hood fire suppression system I, E:xhuust fun with single duct(bath fans) hlauing address: 4 1 W�� ,(�5-- „• Exhaust system apart fn,tn heating or- - City: LIN N state. %.11' 1 d vt piping anddistribution(up to 4 outlets) -�—- '1'v)c: LPO ____ Nu Oil uel pig ing each a ditiunal over outlets lo rocesp ng(schematicrequited) kAddws-s: untc: (r� Number of outlets - �`1_,.'_ then fisted appliance or equipnicu[: Z,� -- Decorative fireplace C M l�p titatr: 7.11': q 2 Insert--type „I - E-mail: Woodstove pellet stove a. Applicom's ,il nalurr Cr t theme—r: - Daly � � -_ Other: Natne (print). Nut all jurisdictions a ceps❑edit cards,please call jtuisd,.uwt ror more infumuaou. Permit fee.....................$ Notice:This permit application Minimum fee................$ _ U Visa U MasterCard expires it•a permit is not obtained ,Ian review(at _ %) Occlu.ud numbe, -'-- ! pig within 180 days after it has been t _ Nwne of cardholder us oldslwwn an credit coed accepted as complete. State surcharge(8%)....$ g TOTAL -....................9 � ---- ---1:ardhuldei signum,e ----”— Ainuunt 440-4617 ldIxUCUM) CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GAGE ENTERPRISES INC PO BOX 1429 CLACKAMAS, OR 97015-1429 Electrical Signature Form Permit #• MST2001-00113 Date Issued: 3127101 Parcel: 2S110DA-07900 Site Address: 10651 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 040 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence. Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Plense have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN- Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: RENAISSANCE CUSTOM HOMES GAGE ENTERPRISES INC 1672 SW WILLAMETTE FALLS DR PO BOX 1429 WEST LINN, OR 97068 CLACKAMAS, OR 97015-1429 Phone #: 503-557-8000 Phone #: 503-657-0142 Req #' LIC 34544 ELE 3-128C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CRAFTWORK PLUMBING INC 7736 SW NII'ASUS AVE BEAVERTON, OR 97008 Plumbing Signature Form Perini` #: MST2001.00113 Date Issued: si:7/01 Parcel: 2S11 ODA-07900 Site Address: 10651 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 040 Jurisuiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence. Path 1 Your company has been indicated as the plumbing contractor for the perrn�t indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN- Building Dept. No plumbing inspections will be authorized uni;l this completed form is received OWNER. PLUMBING CONTRACTOR: RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC 1672 SW WILLAME"'TE FALLS DR 7736 SW NIMBUS AVE WEST LINN, OR 970b8 BEAVERTON, OR 97008 Phone #: 503-557-8C00 Phone #: 644-8698 Reg 0: 1 Ir 79666 P' Fin 20-148PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X k4— __ Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BI IILDING INSPECTION DIVISI( � MST 24-Hour Inspection Line: L .-4175 Business Line: 639-4171 BUP Date RequestedAM `--'PM BLD I-ocation_ Suite _ MEC Contact Person _ _ Ph ��r- C'Z_ PLM Contractor Fh SWR BUILDING Tenant/Owner ELC _ Retaining Wail ELR Footing Foundation Access: FPS Ftg Drain SGN Crawl Drain Inspection Notes Slab -- ---- _. SIT _ Post&Beam — Ext Sheath/Shear - __-- Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler --___----- —_-.--_- - --- - -__-_-- Fire Alarm Susp'd Ceiling - — ---- -- ------ ----- Roof M isc: ---- -- --- -- ------- Final PASS PART FAIL - ------- s-�---- -------- PLUMBING Post& Beam - -_- __— ------ ------- -- ---- Under Slab ----- - �. - --- --- -- Top Out Water Service Sanitary Sewer -----___...---------------- --- ----•- ------ ---_ Rain Drains _ -- ---- - ----- - -- --- -- -- -- ----- Final PASS PART FAIL --- -------__--__ __ -_- -----_---__-__.- MECHANICAL Post& Beam -- --- -- ---- -- -- --- - -- - Rough In C3as Line - - --- -- - - Smoke Dampers PASS PA F.'.IL t ELECTRICA -- -- - - --- ._ iceice ----..._.-_------ _-. -- Rough>n_ ---- --- -.- ---- UG/Slab ____.----- - -------.__— -------------- - Low Voltage Fire Alarm --- _ ----- - ----- PASS P RT FAIL ___-_ _ -_- --._-_ —. ---------- Hackfill/Grading - - — - - '---- - --- - Sanillwy Sewer Storm Drain [ ] Reinspection fee of$ required before ne spection. ay at City Hall. 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: _— -.._ [ ] Unable to inspect no access ADA Approach/Sidewalk __ �� ./ P Other Date Inspector — t Final PASS PART FAIL DO NOT REMOVE this inspection record from the Job site. CITY OF TIGARD Ell III-DING INSPECTION DIVISION MST -ln;;i-Cn�ll 24-Hour Inspection Line: , _d-4175 Business Line: 635 . 171 BUP Date Requested k\— �_AM PM BLD location /L�4' �� / CL �=��+� Suite MEC _ Contact Person — Ph c>h C PLM �C 2 I _ Contractor _ R1SWR _ ELC iIJ LDING— Tenant/Owner Retaining Wali ELR — — Footing Access: FPS Foundation Ftg Drain SIGN Crawl Drain Inspection Notes: SlabSIT _ Post& Beam Ext Sheath/Shear -- Int Sheath/Shear Framing — --- — — Insulation Drywall Nailing ----- -— --- — Firewall Fire Sprinkler -- -- Fire Xarm Susp'd Ceiling --- - ------ --- Roof Misc.----- — _ _ — -- Final — _ — PASS PART FAIL ---- — ---- --- PLUMBING — — Post&Bea•i Under SI +b ----- Top Out — Water Service -- Sanitary Sewer Rajp Drains ___—___- -- ---- --- -- i PART FAIL -----_---_-.- -- --_,_ __ -- MECHANICAL _ Post& Beam -----------`— ---------- -- Rough In --- ---------- — — Gas Line ----- --------- Smoke Dampers -- Final ---------___ _--- PASS PART FAIL_ --— ELECTRICAL -- ---_--�- ----��----- Service - ------ - Rough In UG/Slab _._—_ _— ------------- ------ Lov Voltage Five Alarm _ _---- ----- ---- -- Final PASS PART FAIL __.._—_�_---------- --- — ------ SITE Backfill/Grading --� —� Sanitary Sewer Storm Drain F ; reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I ]Please call for reinspectkm RE: ( ]Unable to inspect-no access Fire Supply Line ^ ADA P /G— of r FeExt Approach/Sidewalk Date _ —Inspector _ Other _ — Final PASS PART FAIL 00 NOT REMOVE, this inspection record from the job site. CITY OF TIGARD PI JILDING INSPECTION DIVISION MST 2A-Hour Inspection Line: ,94175 Business Line: 63. 171 -- BU"' _Date Requested S' AM PM BLD t�- Location �' ! - _. ��'� ,,,� Suite MEC Contact Person _ - t.� PhJ T- �� '—� PLM Contractor Ph SWR BUILDING — Tenant/Owner ELC Retaining Wall ELR Footing Access: . — Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: -- Slab _-- SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceding Roof Misc: Ti no FAS -PART FAIL ---- _ Post& Beam -� - - - Under Slab -A Tap Out Water Service Sanitary Sewer -- -- -" Rain Drains c Final - ---- --- — "- --- --- — PASS PART FAIL -- MECHANICAL Post&beam -- ----------- - - Rough In Gas Line Smoke Dampers incl ----- - --- SS PART FAIL _ CTRICAL -- -"--�� -- -- --� Service Rt ugh In - ------ -- - -- -- -- - UG/Slab Low Voltage -__---- ---- —� Fire Alarm Final PASS PP.RT FAIL _ -.-__— SITE _ Backfill/Grading - ----- — — Sanitary Sewer Storm Drain [ ] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall BI ed Catch Basin Fire Supply Line [ ] Please call for reinspection RE: _-^- [ ]Unable to inspeci-no access ADA Approach/Sidewalk Other Date _ i / Inspector — Ext F c,al PASS PART FAIL J DO NOT REMOVE this inspecti-n record from the job site.