Loading...
10677 SW LADY MARION DRIVE t Y ti n { J J I �cc C �C O 7 R ii I I , 10677 SW LADY MARION Det �,RD MASTER CITY OF TIG PERMIT#: MST2003-00391 DEVELOPMENT SERVICES DATE ISSUED: 9/22/03 13125 SIA Hall Blvd.,Tigard,OR 97223 (50.)639.4171 SITE ADDRESS: 10677 SW LADY MARION DR PARCEL: 2S110DA-06100 SUBDIVISION: EF.ICKSON HEIGHTS ZONING: R-3.5 BLOCA: LOT: 042 JURISDICTION: 'CICS REMARKS: 3'15 square foot 2nd story bonus room addition _ BUILDING RFISSUE: CUSTOM STORIES: FLOOR AREAS A REQUIREO_SETBACKS RFOUIRED CLASS OF WORK: ADD HEIGHT: FIRST: of BASEMENT: sf LEFT SMOKE DETECTORS: Y TYPE OF 1'Sr: SF FLOOR LOAD: 4r SECOND: 315 of GARAGE: sf FRGNT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: t TMP➢ If RIGHT: 00000 OCCUPANCY GRP: R3 BDRM1L BATH: TOTAL: 315 If VALUE: 34. REAR. PLUMBING SINKS: I'IATER CLOSi1TS: WASHING MACH LAUNDRY TRAYS: RAIN DRAIN (RAPS LAVATORIES: DISHWPA- tHS: FLOOR DRAINS SF.WI;R LINES: F RAIN DRAIN^ CATCH BASINS: TUBibHOWERS: GARBAGE DISP: WATER HEATERS. WATER LINES: BCKFLW PREVNTR GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: vtNT FANS: CLOTHES DRYER: FURN>-100K: UNIT HEATERS: HOODS. OTHER UNITS MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _ MISCI.LLANEOUS ADD'L INT PECTIONS '000 SF OR LESS: 0 •200 amp: 0 lou amp: WISVC OR FOR PUMP/IRRIGATION: PER IN',PECTION EA ADD'L 300SF: 201 - 400 amp: 201 - 400 ampi at W/O SVCr DR: 191 SIGNIOUT LIN LT- 'ER HOUR: LIMITED ENERGY: 401 SnO amp: 40 - Ono amp. EAADDL BR CIR. I 1+1 SIGNAL/PANEL: IN PLANT MANU HMISVCIFDR: 601 140 amp: not-amps.1000 V MINOR LABEL. 1000•cmplvolt PLAN REVIEW SECTION Reconnect only: — — �— =4 RES UNITS: SVCIFDR�-225 A.: s 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENERGY _ _ A.Sr RESIDENTIAL B.COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNDSC LT BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL GARAUF OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: W AC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS: Owner: Contractor: TOTAL FEES: $ 742.96 DAVID BROWN WELLINGTON WORLEY INC This oermit is subject to the regulations contained in the 10677 SW LADY MARION Dr: 18151 S UFPER HIGHLAND RD Tigard Municipal State OR. Specialty Codes and TIGARD,OR 97224 BEAVERCREEK,OR 97004 all other applicablea llawaws. All work will be done accordance with approved plans. This permit will expir9 H work Is not started within 180 days of issuance,or if the work Is suspended for more than 180 days. ATTENTION: Oregon law require-,i'JU to follow rules adopted by th- Phone: 503..969-527? Phone: 503-637-1145 Oregon Utility Nof:I':,atlon Center. Those rules are set forth in OAR 95,1 001-0010 through 952-001-0080. You Rag k: LIC 1 5 j;'r,fl may obtain cordes of these rules or direct questions to OUNC by cp:ling(503)246-1967. REQUIRED INSPECTIONS Mechanical InsD Electrical Final Electrical Rough In Mechanical Final Framing Insp Final inspection Insulation Insp Rain drain Insp i C- Issued Sy _�_.-_ _ Permittee Sigr>fature-;-Z- - 'L �- CL-4'L xrr Call (503 R39-4175 by 7:00 p.m. for an inspection needed'the next business day BuiAdi>r>i' Permit Application lication -= -- ----- —�__,�. ______`__ Received , , I3ul,titg -r. DatJe/D : kipf) Pernui No._� 3'(x}r �� n Cit ot�Tl and Planning Approval Other y Date/By: Permit No.. 13125 SW Hall Blvd. JUL 9 Plan Review ether Tigard,Oregon 97223 Date/B 7-a 1`r►3 Permit No — Pbone: 503-639-4171 Fax: 503-598-19601 Post-Review Land Use I,itemcf: www.ci.t.gard,or.usAigliL Date/By. ('ase No _ _ < Contact �, See rage 2 fir 24-hour Inspection Re guest: 503-639-4175 Name/Methr —- 1 tU' c•;.t,t,::-oral!niormaUor� n TYPE OF WORK_ ---^ REQUIRLD DATA: -- �� New construction _ ❑ Demolition I &2 FAMILY DIss" LLIN" Addition/alteration/replacement ❑ Other: ---- — CATEGORY OF CONSTRUCTION Note: Permit fees*arc based on the total value of the work performed. Indicate 1 &2-Family dwellin Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,matcrirts,labor, overhead and profit for the work indicated on this application. •I`�j E_Accessory Build_ � _ __Multi-Family _ � Valuation.. . . . .................... . . .. ............... C D Master Builder Other: . �. •• . .. . .. . � JOB SITE INFORMATION and LOCATION No.of bedrooms:—__ No.of baths:-- Job Siteto address: �� ( f t:/v Total number of floors..................................... _ Bld /A t.#: New dwelling area(sq. ft.)........................ Suite ...... / _ _j5_ p —_-. Garage/carport area(sq. R.)............................ _ Project Nam, ? t,V Covered porch area(sq.fl. Cross sh eet/Di. .. tons to job site: Deck area(sq.fl.)..............•............................. Other structure area(sq.ft.)... ..........•............. REQUIRED DATA- COMMERCIAL-USE CHECKLIST Subdivision: EK;�K,SOt�[. I� Lot#: Z, --- Tax map/parcel #: _ Note: Permit fees*are based on the total value of the work perfotmed. Indicate DESCRIPTION OF WORK the value(rounded to the nearesi dollar)of all equipment,materials,labor, o d,s 2�v rt►1 �D O l 7-1 ON overhead and profit for the work indicated on this application. � ----_,__-— Valuation....................... ................................. $ --` -- u— Existing building area(sq. ;t.)......................... -- - -- --- New building area(sq.fl.).............................. -------------- _ Number of stories........................................... PROPERTY OWNER Q TEN !4T _ Type of construction....................................... _ Name: � � � t Occupancy group(s)- Existing: V-1 -- "0- � .�' f New: ---- -- __ AddresC: lo6 ,77 J10. LADY &A9icac� City/State/Zi _7-16 A,6412 0!Q Phone - 517_? Fax: NOTICE: All contractors and subcontractors are reau;red to be APP ICANTCONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licenses in the t\ Business Name_ ELLINGPP4 (,yo�LE jurisdiction +here work is being perfonned. If the applicant is exempt G Contact Name: -� (Z -�-.Lo ey — _ from licensit g,the following reason applies: \J Address:��'/Sf T. U PP�l2 (6 fF�.A NAbl, -- T<, Cit /State/Zi _,,F CAL) 09- ?70o5�_ --- ------ — — PhonqV6 Fax 31 -! E-mai : BUILDING PERMIT FEES* Please refer to fee schedule. �. CONTRACTOR _ — —_—_-- — Business Name: E,(,l,�h((�Z�( �L� /t(� . Fccs due upon application.............................. S Address: -- -------- City/State/Zip: lJ Q Amount received............................................. S Phone: .� _ Fax: -7 — Date received: CCB Lic. • r o - Author'. Notice: This permit applicatinu expires If a permit k not rbrained,sithin Sign ure: (�_ ` o — Dater 2.Z—03 ilio siayi after It has been accepted as cumpiete. ' -JLLA_TT 0 M_—A_ *Fee ntelhodnlogy set by Tri-County Building Industry tienice 1"a.:J. tl (Please print name) is\Dsts\Pennit Forms\BldgPermitApp.doc 01/03 !� G One-and Two-Family Dwelling Building Permit Application CheckM'ot Reference no.: t '—'— Associated permits: CitynfTigard Cit Tigard�' of g ❑Electrical U Plumbing U Mcch,miril Address: 13125 SW Hall Blvd,Tigard,OR 97223 U other: Phone: (503) 639-4171 Fax: (53) 59R-1966 TUE i 1 i1 ;iYes No N/A 1 Land use actions completed.See jurisdicminu critcria liar concurrent revicev.ti. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 'Verification of approved platflot. 4 Fit cdistrict approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. _ 7 Water district approval. R Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design details and connections must he incorporated into the plans or on a"parate full-size. sheet attr shed to the plans with cross references between plan location and details. Plan review cann:n he completed if copyright violatir„s exist. I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4--ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of casements and driveway;footprint of structure(including decks)-' -ition of wells/septic systems;utility locations;direction indicator;lot arca;building coverage area;percentage of cove .:f,., rpervious area;existing structures on site;and surface orainage. 12 Foundation plan.Show dimensions,anchor b i Its t.ty hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace, ventilation fans,plumbing fixtures,balconies and d( ks 30 inches above grade,etc. 14 (Toss section(s)and details,Show all framing-member sizes and spacing such as floor beams.headers,joists,sub-floor, wall constriction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, _ fireplace co:,slrrction, thermal insulation,etc. _ 15 Elevation views.Provide elevations for new constriction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than fout f,)ot at building envelope. -till-size sheet addendunus showing foundation elevations with cross references are acceptable. 16 'fill bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-prescriptive:path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/mof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. IR Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered systems,see item 22,"Engineer's calculations." 19 Ream calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof mugs)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the projecu jndeLESvi9W 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x I I"or 1 I"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain rel lines or tape-ons. "Mirrored"building plans will he not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "brawn to scale"indicates standard architect or engineer scale. 2R Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must be completed betuic plwl review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614(6rxucoM) 07/2/2003 08:54 50.36502433 OCH PAGE 01 .Ti ll--22•eow ©e:o9A rpm: 6-59 111 07165f,i-1 17,-J P:1-,1 Mechanical Permit ADAlic�n Rmeelved Mrc)mmosl Lb pml* PlawIirgAt►praval Rrrtkling City of Tigard plldR7! tNr m hto t _ 13125 aW Hall 131vd. p1m,it4rvl— tsar t Tigafd,Otegoo 972;:3 _ -x --- �_---�- pMt-pevl. � t AM Urc 'hone: 503-r,W4171 FS-9 503.598 19b0J. ,� D6f�y t,ac Nn --- TntcrtTct: �vw,rv.a.ligestl.nr us Cvatset Jutir: Cse hKc 7 br 24-hour Tm[wc11o0 Kequecr S113•h3�)4175 rJerr,e(k1dtl+r!rt _ K■ Jcrn Wl[rao.ruad■n. _—_....�- �...T�.�V.��Nl1R `-----_. -- _ (,'()1M11M1i�RG7JA[.F6�'.J(:HFD,.�,.UJi�.WiE _�('l►�S_T New Co)iSit11Ct1Mt �tfi0�7t10t] Mechanical pcmul feA'm �ara e bl rn Ata Mftal vxlTn urtlir work Adclltfnn/Tlltii011/n lecenlettt L Qtitrr p� '� Indictor the value(rvund��l to the ntntt►st rintlpr)of aU rgeehanieal matCriele,equilgwnt,labor,overhead mW prubt. — ( ✓UIZY-Q C0 �7_Wr Va1r�:_S Ste Papelfor Vrt1Waduk Tl &2-Fan1i1 1weUin CcAnmCtcial/Lndulstrlal --------- Accaa Buildtn Mulh- mi _ --��-"��-��_ p,.•• ,�__�Teul Mama I311ildcr 11l >rr": ' 1A 1'IUNT Pomace. p�A•nn m;cuudltlont ta, �L,a Ser — -- job mtc eddretic It/�aLtotit shear _!_ 14 w Duct work !a-0 ��10 Suite bidg.r.. .!� — - IC.06 onit hoe wryer c _ _ _ k�M�ee:t NlurrC. �U l�!N — Residemial tnikt CI'r1Ji5 Strec.I Difectioru to job Kite. hydrotuc"n 14AU -- Unit heatm(Cudt net ekcr•ie) (m,sll iin-duct.suVmkd,uw.) t lurJvcnt Lr IUIY of aborad_ _ --� R, enrnr unila 12 15 tiubdtV131lom_ 1��CO r!�s� 1.I�t if Z — (X-M—RI A +lIsom00 ---_--, L Tax r:a el t'0 p�OPrWWWG _ . GpsJitlplax _ __ 10OA Ftitte vent(watK nam lnc _ 10,1}0 Un S KCd11tx ) i0,o0 S,T 14aeiZIC ---- ott0�1'etleteu►rt - _10,00. Wood tltepl6da�ireraTt I 00 to0 AA --- rD��i4s�1t�I NtlI1�L. ���W�--- krnpehne�lodte►It1 cyutpr"em I0.tN1 T�_ AQ.Qiteas D 1,�0�r y�8.6 /rte CkWw y�r atTouri -.. la.cw� Clly/SQQtf!/z1E: � l li -- --- — 3inglc duct eahaast h!Phoon C•„�, aX; (hAr rtmmx,tuilet ccun(>0ttnronln. 6110_ uft room AltKVcTwl space tWA 10.00 _- Nlimc: - cx�trcr. to.9 !+.dPi Iii 1--- f •yam f Arfl!ift.rlA oar tlo Ph -- E-m w1JUFuspdadttdAlnit hWK -- - --—-- -- AA,tIC7K, _ _- nkx healer _ BttSl11C_BB I�Jone.:_ � fireplace _ '� -__ Add»ess - - - Arnpe _ u (:1 lSlatcJZip: a %Voilicy L rests) •• — _ - - - 1'honc _ Fax. _ ' tJthix CCR UG,N. � �! - IF - — Autlia•izad :Ignanrre _C Dou twiner mn rm"t Ftx$71.50 s- • W Plan Re�+ew M ON PrnJtir Fee) _ �`-�' -�� - — - Stmu 5tu�fitr e'A�4 of Pej 5__ - (I Iwwc ptertt nttrrTt) -- - S � 7.Ot:L J'CQMfT pKY. __ Nador Thle prrsaT sprGrnrlen MIM-1 It a Pet"It ret ObWned*;III]n •NR mrtl,■dmW w by T4CrwpIy Ilelldlr�W..-ntry Smi"11s■rd- 1 na drys rlkv h hos Mea snndrd■s reat'iees. ••SJtr piss raqulred rer uterinr All:unib 1Cars�r•r..rniFuntiMtmCr+++ttiApIl" 01 A01 JI4 -P P-PR-1 Till ON: 3llIIr1 I',,: 07-22-2003 06:46 FROWDryer Electric r,^tractors, Inc +5037741046 T-763 P.001/001 F-411 lerhical PermitApplication Permitoo.:FI92115'C'l%. TniJcct/appl no-! E<pirsdme: City of ri`igard Grrnj77garc! Address:13125 SW lcall Blvd,Tigard.OR 9727.7 Date Mucci- _ By, Receipt no. Photo:: (503) 639 41.71 J Ce,r.file no. J Pal ent type• Fax: (503) 596-1960 :'i 11LDING DIVI - -- `---- Lnnd use approval. —.----- Yl &2 family dwnlling or acceawly CJ C,rinmereiaYinductrial a Muld-family G Tenant itnittoVCttlelli I-)New constmction lg Additinnfalterition/rrpl icemcnt 0 Other: v Partial Job addt>zss: o ]' S(� ,art /Qg-_ - 131t]bino.^ Si U9T6 na Tax mal twx lot/aorount no.. - -[rot Filnct:: 5ubt' silo: US �rrL�1._ Lt� Project name: Ure.enplion end location of wo•k an e�.t prntses:_- / 13atimated date of roinpletiOrd!nsowtiota_ Fa WE deb nu: _ _ — y rq.,n Qh• ea.) I.Total oo.irup -Tiuslncssnnmc: cwrrm tial—t eormata�limltypc.• A��`._ t�_,.,�Q��1�_��� -__---t—^ n drrelLn�rmn.InclJJc>tn.tochrdpr�pa Li _.. 1000 s f�ur leu 4 '1 _.�— Phone:503 , / sac 77y/e "m --- EachWelitionalStrsq.ft.orportionthemof 1 f�D no.: � 61et.bels. lic�no_ _L3i�f Limirorfetw�;y,resiAential City/metro Itc.no.: ____ _-_ -- --- Tintltedcrletgy�non•tesldaidal! -- - Eeer1 tnartutactUretl Rome or modular dwelling Scrvko mdror feeder _ 2 Signetum or supra".. iertriclan(r`dorr �-- Darr Sary--icpsof� IOabalLttlon. Sup.elect,name(print): �t Lioerss no: alteration m teloeatlon: 2t1U amps or less _ _ Z _ 101 emPs m ate e - - 1 Nnina(print): _- -- 401 empa l0 600 unpa -- - -- Mailingaddrel. _ __ -_.. r Ol mamt»to tOIXM ��. ..._...._ _. �Y.ntQ:TL2LP; aor ve ts- Fi_.t: G-mail: tteco rotectonly -. Tetnprtrsry eervlces or reredos- Owncr installatEun.'i11e lnsrniindon is being uletic ou ptoperry I awn 1nxitsi11etton,elcn Hnn,m reloation� which is not Intrrid.A for sale,lease.,rent,or r--hannc ec eirAinr to 100 at„t a(it leas Z -_ OAS 447,4-i,479,670,701. 20t- ------ - - -- - --- a tn400atnpt � _ uwacr6 al naturr. --- Dace: {o► Mpg a-- - 2 -- ranch clrvaita-ecw,nTterntiotr, nr extemlon per panel: Name: A. prl;fr r branch circuits with puichgw of servler or feeder fee,each brunch rltruit 2 Add.re s - -_--_ -.-- - , U. F"tnr branch clmdts wrtnnur putiitasc C�yry. Stater l Fax: )?ifnat tech neeiu ms-1 -bt-,q—T-ti� Mise.(Service nr Aeedernot Inclvdad):- 5eoh pump or itti auto circle 2 4 9ervl000ra225amp:-oernn»ttSrJ ❑Na.deh+an fuDib --_----- Each signoronl-Ine_lrg�_nnl(- - _ _ _ 2 0Snrviceover 320arnps-retingof1&2 ❑Hazurdayslocation Si nolefrcuit�s)oralinnitcnanrrgypanrl, tsmilydwellings QBuilditigcivet 10,000squarcf"tfcu:-Of R Cltiysmmovct600volts nonflnal moterWnrntlrionharinone awcture ettcnaon,oro>rtcnelen• -- _-��_ __.__ _ ___ ,18ulldingover mice slorieS Urmtk,,OA)anrincrrow. -13P rt don, -_T ---_ ra Occup:.nt bort over M primam to htnrtufacwrerl rwetunu or RV park -� nr addttlorcal i-p-linn over the alto wnbk kt Bury of rhe attme:-�S 0 EgreiMighdngplon •.-- Perinspecllon - - 9urwssft ecu of place with any of Me above, iavutl a on ee -- lt}e ebore tyre teat tatble to tempo �gRelrtafttoe Service• Utter ------- — -- - -._-. ' _ tam_.—_- _ __- --- - -- - _ — — -----� Permit fee..................... Not al{luri�dirtia+aa erar4a a u eertSt,plca+e cdl I cr:on tm r+m�tri rroyton. Notice This pet nit epplicotion ��review(at $ O vss t7 mutert'tud expire¢If a permit is not obtain►d -- cae.s within 1 R0(11W after It has been State surcharge(18%) ,...$ nccapted as complete. TOTAL. ........... ..........S Malagamnatlls tatJwf ntd] TUI. -22-200--3 TI-IE 08.33AM 1D: Pilt�E 1 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (CO3)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received Date Requested _1 - �-- AMPM _—___ BLIP Location 10 C07 7 Contact Person — _ - Ph( _) ?RR -_ PLM Contractor _ Ph(----) _ SWR BUILDING TenandOwner _ _._._ El.c Foundation 71-(7s—s: Ftg Drain ELR Grawl Drain _ Slab Inspection Notes: n'e�� ��� SIT Post&Beam /� - -- - -- -- Isf Shear Anchors --- --- -- Ext SheathJShear Int Sheath/Shear Framing Insulation Drywall Nailing ---- Firewall Fire Sprinkler —- Fire Alarm Susp'd Ceiling --- --- Roof PART FAIL - - -- - - - - - PLUMBING R_ Post&Beam Under Slab Rough-In Water Service - —_ Sanitary Sewer Rain Drains Gatch Basin/Manhole Storm D ain - ---- ---- -- Shower Pan Other: - Final PASS PART FAIL MECHANICAL _ Post&Beam Rough-In _ Gas Line Smoke Dampers - Final FAIL -- - - - _ ELECTRICA 84 _ ce Rough-In UG/Slab ----- - - -- Low Voltage larm Finav u Reinspection fee of$_ _.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. TMk PART FAIL SITE _-- J__j Please call for reinspection RE:_ _ ❑ Unable to inspect-no access Fire Supply Line ADA -' 24 Approach/Sidewalk Date ! ZO � Inspe r Other:------_-_- Final DO NOT REMOVE this inspection record from the site. PASS PART FAIL j CITY O F T I G A R D MASTER PERMIT PERMIT#• MST2000-00485 DEVELOPMENT SERVICES DATE ISSUED: 11/21/00 13125 SW Hall Blvd., Tigarc., OR 97223 (503) 639-4171 SITE ADDRESS: 10677 SW LADY PAARICN DR PARCEL: 2S11ODA-08100 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LUT: 042 JURISDICTION: TIG REMARKS: Construction of new single family detached residence, Path 1. bUIL.)ING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NG W HEIGHT: 20 FIRST 1.646 sf BASEMENT: of LEFT. SMOKE DETECTORS: Y' TYPE OF USE Sr FLOOR LOAD: 40 SECOND. 1,528 of GARAGE: 711 of Fn'7NT: ;n PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of .SIGHT: VALUE: E 293,335 00 OCCUPANCY GRP: R3 BDt'M. 4 BATH: 3 TOTAL. 1.174 00 of REAR: 4'� PLUMBING SINKS: 1 W',TER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN. 100 TFAPS. LAVATORIES: 4 LISHWASHERS: ' FLOOR DRAINS: SEWER 1_INES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 4 GAPBAGE nISP. 1 WATER HEATERS. 1 WATER LINES: 100 BCKFLW PREVNTR I GREASE TRAPS: OTHER rIXTURE.S. MECHANICAL _ FUEL TYPES FURN<100K BOIUCMP<3HP VENT FANS: F, CLOTHES DRYER: 1 (;AS FURN—100K: i UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: bpi FLOOR FURNANCES VENTS: 1 WOODSTOVES. GAS OUTLETS: 1 ELECTRICAL _ ti RESIDENTIAL UNIT_ SERVICE FEEDER TEMP SRVCIFEED_ERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 1 i 0 - 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: r, 201 - 400 amp: 201 - 400 amp1st WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp EA ADDL SR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FD- 601 1000 amp. 601.amps-1000v- MI—)R LABEL. 1000.amplvolt PLAN REVIEW SEC71',N Reconnect only: >=4 RES UNITS SVGFDR>=225 A.: >800✓NOMINAL CLS AREA,'SPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTE161 AUDIO 8 STEREO, FIRE ALARM: INTERCOMIPAGING. OUTDOOR LNDSC LT. BURGLAR ALARM OTH: BOIL ER: HVAC: !ANDSCAPEARRIQ: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: iNSTRUMENTAT,ON: MEDICAL.: OTHR. HVAC: DATAITELE COMM NURSE CALLS: TOTAL 0 SYSTEMS Contractor: TOTAL FEES: $ 7,356.49 Owner: This permit is subject to the regulations contained in the RENAISSANCE CUSTOM HOMES INC RENAISSANCE CUSTOM HOMES Tigard Municipal Code, State of OR Specialty Codes and 1672 SW WILLAMETTE FALLS DRIVE 1672 WILLAMETTE FAI LS DR all other applicable laws All work will be done in WEST LINN,OR 97068 WEST LINN,OR 97068 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Phone phone Oregon law renuires you to follow rules adopted by the Oregcrl Utility Notification Center Those rules are set Reg N: LIC 049955 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1997 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Grading Inspection PosUBeam Merhanica Mechanical Insp Framing Insp Gas Fireplace Backflow Preven.tor Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Mechanical Final Foundation Insp Footing/Foundation Dr: Electrical Service Low Voltage Water Line Insp Plumb Final Issued By : _, _. Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the nextt business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00337 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/21/00 SITE ADDRESS; 10677 SW LADY MARION DR PARCEL: 2S1 10DA-08100 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: '142 iUFISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE- Remarks: Sewer connection permit for new single family residence. Owner: a --- __ FEES RENAISSANCE CUSTOM HOMES INC Type By rate Amount Receipt 1672 SW WILLAMETTE FALLS DRIVE WEST LINN, OR x7068 PRMT CTR 11/21/00 $2,300.00 27200000000 INSP CTR 11/21/00 $35.00 2.7200000000 Phone: 503-557-8000 Total $2,335.00 s_ Contractor: Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rides and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited 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 T hose les 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) 21987. Issued by: r tt Permittee Signature: �l Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day r7,-I i/,,� �-w .— � ✓�`'��i caw /�•3�� � Building Permit Application -- i)atercceivcd: Perri:tno,:'A?STQD'7r"p ?7D .I`- Cit of Tigard y � PmjccUappl.no. Expire date: city of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 --Date issued: BY Receip tno.: Phone: (503) 639-4171 Fax: (503) 598-1960 �� � 'a%Qnn �.- Casc file na: Payment:ype. Land use approval: 1&-2 family:Simple complex: L" � , TYPE OF PERMIT I &2 family dwelling or accessory U Commercial/industrial U Multi-family *ew constniction U Demolition— U A(ldition/alteration/replacemt n1 U'renant improvement U Fire sprinkler/alarm li 1 ' 1 Job address: �� '� S G /V1 111Np�V Bldg.no.: Suite no.: fit; 2 Block: Subdivision: _ �'t r Tax . ,p/tax lot/account no.: Project name: Description and location of work or premises/special conditions: V�' --f IM 1 1 tri , t Name: Mailing address: �/ j� W _ F� 1 &2 fancily dwelling: city. W (� tit:tte: ZIP:��_ Valuation of work........................................ $ -- Phone: _ Fax: Email: No.of bedrooms/paths................................... .... Owner's representative: ,�N�1 Total number of floors........................ . - ji Fax: f? m;t;l. New dwelling area(sq.ft.) .......................... AP PLICANT Garage/carport area(sq.ft.)......................... _ Covered porch arca(sq,ft.) ......................... _ Name: - - Deck area(sq.ft.)...... .................. . .........._ �Mailing address: t Other structure area(sq.ft.)........... .. .......... City: __ -- — Stn:, ill — - ('ommercial/industriallmulti-family: Phone: I a. I r,iail ............ $ Valuationof work......................... - ---. 1 ' F,xisting bldg.arca(sq.ft 1 ......................... 7Bnname: _._ Ncw bldg.area(sq,ft.)........... .................. wt= _--.---- Number of stories............ ..................... _�State: ZIP: _ Type of construction.........:J...... _-- Phone: Fax _.T_.. E-mail: - - Occupancy group(s): Existing: -- CCB no.: New: Pity/nu un li. n Notice:All contractors and subcontractors are required to be ARCH ITECTIDESIGNER licensed with the Oregon Construction Contractors Bop..id under �n provisions of ORS 101 and may be required to be licensed in the Name: PD 4 _l!iV- — —— jurisdiction where work is being performed. If the applicant is Address: j� _ - exempt from licensing,the following reason applies: Cit State Contact person: AM_ Plan no.: _� ----- — ^---- - - I'hc,nc. Name: �, �t contact person: 4AJS,y_ Fres due upon application ........................... $ _— Address: 7j'�.� _— Gate received: _ - --- $— State:: ZIP: Amount received .........................................City: Please refer to fee schedule. Phone: _ Fax: E-mail• — 1 hereby certify I have read and examined this application and the Not alt jurisdictions accept credit card+,please call Jurisdiction for more information attached checklist. All provisions of laws and ordinances governing this U Visa U MasterCard work will he complied w' helper specified herein or not. �'n �y� credit card number_ — --_ -- �ire'1-- Date: 10 IG�/ Nan-of cardholder u shown on credit card Authorised si nature: — S Print name _� ---- Canthol er dgnautre Amount Notice:Phis permit application expires if a permit is not obtained within 190 days eller it has been accepted as complete, 4J0-4613(WWOM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: a Associated permit.;: City of Ti 'ty Tigard U Electrical J Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U ether: Phone: (501) 639-4171 Fa;,,: (503) 59h-1966 I Land use actions completed.See jurisdiction criteria for concurrent reviews. - 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. _ 3 Verification of approved platflot. _ 4 Fire district __A approval required. _ 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Solis report Must carry original applicable s.amp and signitture on file or with application. 9 Erosion control U plan U permit required Include drainagc-way protection,silt fence design and fixation of catch-basin protection,etc. __ 10 _ Complete sets of legible plans ,lust be drawn to scale,showing conformance to applicable local ant state building codes. Lateral design details and connections must be incorporated into the plans Aron a sepatate ult-size • sheet attached to the plans with cross references between plan localign and deta0s,Plan review cannot be(jriipleted if-copyright violations exist, .- I Shelplot.plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevatiods(tif there is more than a 4-fl.elevation diflerenffal,plan must show contour lines at 24 in(ervals);location of easements and driveway;footprint of structure(including dmks);location of well%lsepfic systems;utility Iocafloits;direction indkcator;lot ;area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.,, _ 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent .size and location. I { Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Crons section(s)and details.Show all fram;ng-member sizes and spacing such as floor heams,headers,joists,sub-floor, wa!f construction,roof construction. More than one cross section may he required to clearly p(rtray construction.Show derails of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,faotings and f';...ldation,stairs, firenlace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for auottrons and rrmodcis. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate()?tails and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all fl(N)rs/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. — 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered _systems,see itew 22,"Engineer's calculations." • 19 Beam calculations.Provide two sets of calculations using current cote design values for all behrnii and knultiple joists over 10 feet lone and/or any heam/joist carrying a non-uniform load. .^ _ Tr_ 20 Manufactured Iloorlroof truss desijn details. 21 Energy Code compliance.Identify the prescriptive path or prov+ Argas-piping schematic is required r for four or more appliances. – 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the pmject under review. Roll 12133mmasffm�_ 23 Five(5)site rlans are required for Item I I above 24 25 -- --- - - -- 26 27 28 Checklist must be completed heron plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4404614(&MCOM) Mechanical Permit Application Datereceived: Permit no.: City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By Receiptno.: Phone: (503) 639-4171 -- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 1 &2 family dwelling o, accessory U Commercial/industrial U Multi family 'Tenant improvement New construction U Adclition/alterationh-eplacement U Other: Joh addfess: ment 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$ — Lot; %► 1 Block: Subdivision: -See checklist For important application information and Project name: 1 jurisdiction's fee schedule for residential permit Ice. City/county: 'T'jA_ A& ^ FLIP: �7 t.L�-- Description and location of work m premises; t Gru y& D'cc(ca.) llltAl Est.date of compleli,m/inspection_: Description Qt Res.onl y Res.only Tenant improvement or change of use: — HVAC: Is existing space heated or conditioned?U Yes U No it co' n�itioAir handling unit _gu ci M ning(site plan required) Is existiltg space insulated?U Yes U No 1111F.-_ Alteration of existing C syste^i of,!r/compressors Business n,mmc. Staic hailer permit no.: _ _ [lp� _- HP Tons BTU/11 _ Address: �,'fljp �J __. __ d,.�i. ire smo cdamper ductsmokcdctccturs City: (,j, �tatc:O� 7.11':— eat pump(sae plan require ) _ 1'honc: ( � Fax: E-mail: nstaITrcpacefurnnc urncr 1T1 i Including ductwork/vent liner U Yes U No CCB no.: IZ 00. __- �j� (�2_� IitstaII/heplace/re locate eaters-suspen c . "it /metro lic,no.: wall,or floor mounted tune(please. print): (/ -- _ - Fent fora iance other than im nace of gerat on: Absorption units— _ BTU/11 Name: HP - ---- - - — —----- Cum pressors HP Address: —�-_. --- -- --- nv momenta ex aust an vent s— on: City: _ ,Slaw. �7.IP. — Appliancevent Phone: Fax: E-mail: )ryerex gust _ 0o a, ype res .kite men/ha�mnt hand fire sut pression system Name: Exhaust fan with single duct(hath fans) Meiling address: Exhausts stem a art from heating or;KC - — City: LIP: �Tuyp(r piping p gdistributionan (up to 4 outlets) LG NG Oil Phone: E-mail: Fcin _ each additional over 4 out els ro;ess p p ng(schematic require ) _ dumber of outlets _ Name: Address: User ste app once or eqa pment: Address: Ikcorative.fireplace City: State: 7.1 P. nsert--type _ Phone: Fax: E-mail: on stov pc let stove ` O►fier: _ I j Applicant's signature: _ Date: _ t ter: Name (print): Not all jutiWictions accept credit cards,please call jurisdiction for more information. Permit fee.....................$ Uvisa U MastcrCord Notice:This permit application Minimum fee................$ expires if a permit is not obtained Plan review(at __ %) $ — Ovdit card numlwr. �__—.__.� — n- 1 ,r/ - within IRO days Ager it hes been — - p State surcharge(8%)....$ -- as complete.Nutte of cardholder as shown an credit cud accepted$ p Cudltolder slgnnmre �� Amouni 440.4617(NtrllCOMI MECHANICAL PERMIT FEES COMMERCIAL. FEE SCHEDULE: 'I & 2 FAMII_Y DWELLING, FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1100 to$5,000.0 Minimum fee$72.5_0 T2hle 1A Mechanical Code Qty (Ea) Amt $5,001.00 to$10,u 10.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU I $1.52 for each additional$100.00 or including ducts&vents_ 14.00 fraction thereof,to and including 2) Furnace 100,000 BTIJ+ _ $10,000.00. including ducts&vents _ 1740 $10,001.00 to$25,000.00 5148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent _ _ _ 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $25,000.00. _ or(four mounted heater 14 00 $25,001.00 to$50,000.00 $379.50 for the first S 25,000.00 and 5) Vent riot included in appliance permit $1.45 for each aCsitional$100.00 or _6,80 fraction thereof,to and includinrj 6) Ropair units $50,000.00. _ 12 15 $50,001.00 and up $742 06 00 for the nrst$50. 0.00 and Check.1 that apply: Boiler Hee; Air $1.20 for each addilional$100.00 or For items Y-11,see or Pump Cond _ fraction thereof. foot otva below. Cim " _ ** 7) -3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE_ - to 100K BTU — 14.00 Value Total 8)3-15 HP;adsorb 25.60 emit 100k to 500k BTU _ _ De.icri�tion: Qty (Ea' _ Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5.1 mil BTU 3600 ducts&ve its _. _ 10)30-50 HP;absorb Furnace> 100,000 BTU including 1,170 unit 1-1.75 mil BTU 52.20 ducts&veno. 11)>50HP absorb -- -- — Floor furnace including vent 955 unit>1.75 roll BTU I__ 87.20 ___ Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM floor mounted heater _ _ 10.00 _ Ventnot Included in applicance 445 13)Air h tndling unit 10,000 C�fvl+ , permit 17?o Repair units 1.95 <3 hp;absorb.unit, 955 14)Nun-port4ble evaporate cooler 10 00 to 100k BTU _ -- — A -- 3-15 hp;absorb.unit, 1,700 15)Vent fan connected to a single duct 680 101 k to 500k BTU ----- 16)Ventilaticn systern not included in 15-30 hp;absorb.unit,501k to 1 2,310 ap liacce permit 1000 _ mil.BTU — 17)Hood served by me5hanical exhaust 30-50 hp;absorb.unit, 3,400 1000 _ 1-1.75 mi! BTU 18)Domestic Incinerators >50 hp;absorb.unit, 5,725 Y7A 0 >1.75 mil.BTU -- 19)Commercial or industrial type Incinerator nd AnAir ha _unit to 10,000 cfm 656 __- _� 69 95 Air handling unit>10,000 cfm 1,170 _.� _- -� 20)Other units,including wood stoves Non-portable evaporate cooler 656 _ _- 10.00 Vent fan connected to a single duct _ '146 21)Gas piping one to four outictg Vent system not Included In 656 5.40 _ appliance perrnit — _ - 22)f•Aore than 4-por outlet(each) — Hood served by mechanical exhaust _ _656 _ 1,00 Domestic InrAnerator 1,170 Minimum Permit Fee$72.50 SI;BTOTAL: a Commercial or Industrial Incinerator 4,590 __ Other unit,including wood stoves, 656 - ___ 8%State Surcharge Inserts,etc. Gas PIN 1-0 outlets _ 360 _ � 254r.Plan Review Fee(of subtotal) 3 Each additional outlet 63 _ Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: S VALUATION: - —_.------- -- — -- - Other In_pectlons and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour. 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) $72 50 per hour 3 Addition:ii I.ar review required by changes,additions or revisions to plans(minimum charge-one+alf hour)$72 50 per hour State Contractor©eller Certification requlrrd for units>2001,STU. "Residential AIC requires site plan showing placement of unit. I:\dsts\forms\mech-fees.doc 10/11/00 Plumbing Permit Application Date received: Permit no.: City of Tigard Sewer permit no.: Building permit no.: L' Address: 13125 SW Hall Blvd,Tigard,OR 9',/23 Ciryn(Tigard phone: (503) 639-4171 3'roject/appl.no.: _ Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: I &2 family dwe;ling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New constriction U Addit;o.rialteration/replacement 0 Food service U Other: 1 �B(11 h address: Descripliou Qt . Fee(ea.) Total —�� -- Ne-v l-and Morally dwellings only: dlt.no.; Suite.no.: (includes 100 f.for each utilh y connection) ''ax map/tax.IoUaccount no.: _ SFR(1)bath Lot: 1� Block Subdivision: _ — SIR(2)bath _— Project name:_rd'Vjr-�Vp _ SFR(3)bath City/county: 71P: 0117 V '5� Each additional bath/kitchen Description and location of work on premises:V _ Site utilities: 64 MI&Lj�_ lent— Catch basin/area drain — E%t,date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. lin. ft.) Manufactured home utilities Business name: L � _ _ _ Manholes _ Address: Rain drain connector City: Slate: ZIP; Sanitary sewer(no.lin.ft.) Phone:-5 'Zo Fax: E-mail: Storni sewer(no.lin. ft.) --- CCB no.: "j0j&r&&r Plumb.bus.reg.no: ?,p� Water service m: lin. ft.) _City/metro tic.no.: �- - Fixture or item: Absorption valve Contractor's representative signature: Back flow preventer Print name: D:mtc; 1 10 AO Backwater valve�—_ _ Baav sins latory Name: Coth les washer — - ---- -- Dishwasher Address: -- — Drinking fountain(s) -- - - City: State: "LIP_ Ejectors/sump Phone: I ax: E-mail: Expansion tank Fixturelsewer cap (print): �, � Floor drains/Boor sinks/hub Name Garbage disposal Mailing address: 'L _ tL17, _ 1f5se bibb City: (� State: Kll Z- i(/'�_ Ice..mak^t --- hone:551. Fax: E-mail: -Interceptor/grease trap Owner instal latiorvresidential maintenance only: The actual installation Primtr(s) will be made by me or Cie maintenance and repair made by my regular Roofdrain(commercial) - employee on the prop of n a5 per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si natur:: �--- Date: �Q Sum - Tubs/sh_ower%sh(wetLLan _ Urinal Name: ,— _ — Water closet _— — Address: —_� Water heater City: State: _ ZIP: Other: ---i— -� — Phone: Total � Nm till jursdictions accept credit earls,please call jwiRdiction far more Information. Notice:11mis permit application Minimum fee..............) $Visa O MasterCexpires if a permit is not obtnined ard Plan review(at — 3F,) $ U .—�--_ c•redit�and number:.____ . —1—� within 180 days alter it has been State surcharge(8%))....$ --- ------ Expires accepted as complete. TOTAL . ......... ...........$ Name of cardholder u shown on credit crud S -- - Cardholder signature --- Amount J 4444616(6/ WOM) PLUMBING PERMIT FEES: - PRICE TOTAL New 1 and 2-family dwel;ings only: FIXTURES individual QTY ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the final ft. QTY (ea) AMOUNT �B.oU for each utility connection_ Lavatory One 1)bath $249.20 Tub or Tub/Shower Comb 16.60 Two 2 bath $350.00 Shower Only 16.60 Three 3)bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 _8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW2.5%OF SUETOTAL _ TOTAL Garbage Disposal 16.60 --- -�- --� Laundry Tray 16.60 Washing Machine 16.60 Floor grain/Floor Sink 2" 16.60 3,. ,660 -- PLEASE COMPLETE: 4" 16.60 Water Heater O conversion O like kind 16.60 Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. � •- Capped MFG Home Now Water Service - 46.40 _ Sink MFG Home New Sar4Stt,r•n Sower 46,40 Lavato T_ Tub or tRighow9r Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet _ Urinal _ •' Other Fixtures(Specify) 16.60 Dishwasher G a e Dis owl_ Laundry F�oom Tray - Washing Machine eFlod Drain/Sink: 2" Sewer-1st 100' 55.00 Sewer-each additional 100' 46.40 - 4" - Water Service-1st 100' 55.00 _Water Heater _ _ adnal 200' - Othbr Fixtures W ' ater Service-each ditio46.40 t " _ _ (Specify) _ - Storm-&Rain Draln-1st 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 _ Commercial BacK htuw Prevention Device 46.40 ---- Fesidential Backflow We•rention Device' 27.55 '.;etch Basin 16.60 - _- Inspection of Existinn F.,mbing or Specially 72.50 Requested Inspectionsper/hr _ COMMENTS REGARDING,ABOVE:r Rain Drain,single family dwelling 65.2.5 t ---- Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram is required if -_ Quantity Total is >9 --- - - i "SUBTOTAL - -� 8%STATE SURC14ARGE -- "PLAN REVIEW 25%OF SUBTOTP,L Required only If 8xtu­qty total is>9 TOTAL b "Minimum permit fee is$72 50•8%state surcharge,except Residential Backflow Prevention Dnvice,which Is$36 25-8%state surcharge "All New Commercial Buildings require plans with Isometric or risci diagram and pian review 1\ds'-;\fonns\plm-fees,doc 10/10/00 Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: —_ Expire date: _- Cin ofligard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dateissucd: By: Receipt no.: Phone: (503) 639-4171 — ---------- Fax: (503) 598-1960 Case file nn.: Payment type: Land use approval: I &2 family dwelling or accessory ❑Commercial/industrial U Multi-lanlily _ U Tenant improvvincn! New construction LI A(ldition/alteration/replam cecru LI Other: _ U Partial 1 ' Job address IIIdg. nu.: Suite no.: Tax map/lax lm) a:count no.: Lot: 42, Block: Suhdivisinn: � -- Project name: FiJescripti,on and Inrohon of work on premises: -- — Estimated date of completion/inspection: 9119, Job no: Fee Max — - D"cripllon Qt . (ea) Total no.Ins t Business name: a�f � _ Ne"t"Identlal-%Ingle or multi-faintly per Address: —_J f ��-- _-- _ — _ _ docllingunit.IncindesAuachedgarap-e. City: 4LA&KAVHftSlalc T.IP: Q'!j yeniceincluded: Phone: _r Fax: _ E-mail: MOON n.or less - Bach Additional 500 sq.ft.or portinn thereof CCB no.: fft Elec.bus.lic.no: Limited energy,residential 2 City/metro liC.no,: _ Limited energy,non-rrsidential _ 2 Hach manufacnued home or modular dwelling Signature of su rvlsin g electrician(required) _Date Service and/or f^cder _ 2 - Sup.elect.name(print) License no. alterServiatioes n feederslocal Installation, alteration or relocation: t 200 amps ur less _ Name(print) �N��' 201 amps to 4(x1 amps __ 2 401 amps to G(r(I amps __ 2 — Mailing address: I K�) e(II Amps to I(Nxl Amps 2 City: W0.5r L Siete' ZIP: 41p6rityOver 1000 amps or volts 2 Phone:97'51;f64W I Fax: I E-mail: Reconnectonl I (Avner installation:The installation is being made on property I own Temporary services or feeders• which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479 i7( Ol. 2(xl Amps or less 2 �f 201 Amps to 400 amps 2 Owner's signature: _ v` Date: A630-1m 401 to 600 ams 2 P.ranch circuits-new,alteration, or extension per panel: Nance' v—�— — _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit _ 2 Clly ' B. i ie for branch circuits without purchase Slate:— l.I1 ---- -- -- ---�- of service or feeder fee,first branch circuit: I'hone I ar: 1: mail: ----- Each additional branch circuit: Mlsc.(Service or feeder not Included): r ce over 225 amps-commercial U I Irnldt-care facility Each pump or irrigation circle _ 2 ce aver 320 mops-rating of 1&2 U l Inzardous hxation Each sign or outline lighting 2 y dwellings U Building ov. 1(I.fxlo squme feet four or Signal cirruit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,4(xl amps or more +Ikscription: U Mcupant load over 99 persons U Manufactured structures or RV pink F,ch additional Inspection over the allowable in any of the above: U Egress/lightingplan U(ether Perinspection Submlt___gels of plans with any of the above. Investigation feeThe above are not applicable tet temporary construction service_ - --- -- Not onjurivdictione accrpt credtin cardv,please call jurisdiction for more infonnntion Notice:111is permit application Permit fee ........ .......$ -- --- U Visa U MasterCard expires if a permit is not obtained Plan review(al .__ d7) $ dledit card nninbet� __.___—_ .___L_�___. within 180 days after it has been State surcharge(9%)....$ - Ggpires accepted a:complete. TOTAL $ Nrane of cardholder av shown on credo card Cardholder signature --- --Amounn un.ir,r•ihAWIA rr.ti Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee........................................�....... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 4 Audio and Stereo Systems 1000 sq,fl.or less $145.15 _ Each additional 500 sq ft.or $33 4U 1 portion thereof _ Burglar Alarm i Limited Energy _ $75.00 i Each Manul'd Home or Modular2 LJ Garage Door Opener" Dwelling Service or Feeder $90.90 _ _ Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation $80 30 2 200 arnps or less 2 Vacuum,3yslems' 201 amps to 400 amps _ _ $1u•..d5 401 amps to 600 amps $160.60 2% Other 601 amps to 1000 amps $240.60 2 Over 1000 amps or volts _ $454.55 2 — -- — Reconnect only $6685_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66,85 _ 2 (SEE OAR 918-200-260) ' 201 amps to 400 amps $10030 401 amps to 600 amps _ $133.75_ _ 2 C Over 600 amps to 1000 volts, fleck Typo of Work Involved: s, '•b"above. Audio and Stereo Systems Branch .,ircults New,alteration or extension per panel Boiler Controls - a)The fee for branch circuits with purchase of service or Clock Systems feeder fee. 2 Fach branch circuit $6.65 b) The fee for branch circuits Data Telecommunication Installation without purchase of service or feeder fee. Fire Alarm Installation I irst branch circuit $46.85 Each additional branch circuit $6.65 _ .❑ HVAC+ Miscellaneousa r F 14, (Service or feeder not included) Instrumentation , Eaclr pump or irrigation circle $53.40 Each sign or outline lighting $5340 Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension $7500 — _-- Landscape Irrigation Control' Minor Labels(10) $12500 E-ch additional Inspection over Medical the allowable In any of the above Per inspection $f 2 50 Nurse Calls Per hour $6250 _ In Plant $73 75 Outdoor Landscape Lighting" Fees: n Protective Signaling Enter total of above fees $ --_-- Other--- ---�-- — - 8%State Surcharge $ — _ Number of Systems 25%Pla Review Fee see"T'lan Review"sectuxi o $r' ' No licenses are required Licenses are required for all other installations front of aiViGation Total Balance Due $ Fees: Enter total of above fees ❑ Trust Account p S 8%State Surcharge — - Total Balance Due : 1 AsIs\f0 rms`.cIc•fees,doc 10/09/00 EI., N 89'53'03" E 65.00' 400 ' ! 06 04 �o o r 0 15,50' g O a i.i 0.50' 22.60 I r I 7 00' 1 W I I 4vO U� 0 Ln Z I '— I r'm' I I 5.C), 7.67' ',',c, k�' 4 gl 22.00' 5.QV n,d3' Ji tih O O l!7 N R=525A .�0' �=-65-Z5, S. W. LADY ��►� N MARION DRIVE SCALE DRAWING _ LOT 42 ERICKi HEIGHTS ' S.E. 1/4 SEC. 10, T,2S., R.1 W., W.M. 10(pl"I c� LAPY "91014 UWVe CITY OF TIGARD _ WASHINGTON COUNTY, OREGON JULY 12, 2000 _ C:c!ri I erlirio Concepts Iric . i DRAWN BY: MSG CHECKED BY: WGDIII _SCALE 1"=20' ACCOUNT # 115 64C 82nd Drive Gladstone, l .4on 97027 M: MLI L42LRIrK 503 650- 0188 fox 503 650-0189 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 #: MST2000-00485 Date Issued: 11/21/00 Parcel: 2S110DA-08100 Site Address: 10677 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 042 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence, Path 1. Your company has b,en indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your 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 INC GAGE ENTERPRISES INC 1672 SW WILLAMETTE FALLS DRIVE PCS BOX 1429 WEST LINN. OR 97068 CLACKAMAS, OR 9701',• 141'4 Phone #: 503-557-8000 Phone # 503-657-0142 Rep #' 6189 LIC 34544 ELE 3-1280 AN INK SIGNATURE IS REQUIRED ON THIS FORM X r _ Signature of Supervising Elfctrician 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 NIMBUS AVE BEAVERTON, OR 97008 Plumbing Signature Form Permit #: MST2000-00485 Date Issued: 11/21/00 Parcel 2S1-IODA-08100 Site Addross: 10677 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 042 Jurisdiction: 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 permit 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 until this connpleted form is received OWNER: PLUMBING CONTRACTOR: RENAISSANCE CUSTOM HOMES INC CRAFTWORK PLUMBING INC 1672 SW WILLAMETTE FALLS DRIVE 7736 5W NIMBUS AVE WEST LINN, OR 97068 BEAVERTON, OR 97008 Phone #: 503-551-8000 Phone #: 644-8698 Reg #: I Ir 79666 PI M 20-148PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X ))x14411 Signature of Autl prized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF T I G A R D ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00075 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 3/27/01 SITE ADDRESS: 10677 SW LADY MARION DR PARCEL: 2S110DA-08100 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 042 JURISDICTION: TIG Prosect Description: I-- A.RESIDENTIAL _ B.COMMERCIAL _ AUDIO& STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: Cont,actor: RENAISSANCE CUSTOM HOMES INC GREENLINE INC 1672 SW WILLAMETTE FALLS DRIVE PO BOX 230755 WEST LINN, OR 97068 TIGARD, OR 97223 Phone: 503-557-8000 Phone: 968-1978 Reg#: 1-Ic 103033 E_E 34-397CL FEES Required Inspections Type By Date _ Amount Receipt _ Low Voltage Inspection PRMT CTR 3/27/01 $75.00 2720010000 Elect'I Final 5PCT CTR 3/27/01 $6.00 2720010000 Total $81.00 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 will expire if work is not started within 180 c.ays of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to fol ow 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 at (503) 246-1987. Issued by _ _ Permittee Signatui j OWNER INSTALLATION ONLY The installation is being m e property I own which is not Intended for sale. lease, or rent. OWNER'S SIGNATURE: _ DATE: Z in CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection reeded the next business day Electrical Permit Application Ilatereceived: ( Permit no. F_MC- City of Tigard Project/appl.no.: Expire date: Cin-r,/'I i� ,rd Addresk: 13125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Receipt no.: Phoue: (503) 639-4171 — — — - rax: (503) 598-1960 Case file no.. Payment type: Land use Lpproval: I k 2 family dwelling or accessory U Commercial/industrial U Multi-gamily U'renanf improvement New construction U Addilion!alteration/replace mail U Other _ U Pa,-tial JOB SITE INFORMATION Joh address: (,�DyM Bldg. nn.: Suite no.: ITax map/tax lot/account no.: Lot: 42, block_ Subdivision: Project name: description and location of work on premises: -- Estimated date of Torr Ietirm/inspcclion: JIM Job no: _ _ tee Max Business name: �r,�� -^ -- --- Descripliun Qly. (ea.) Total no.ins New rrstdential-single or multi-family per Address: _ T �LJwellinRunit.lnclurksatlanc�dgarnge. --- City: _ 5tatc: 7.IP: 1 Serviceincloded: Phone. I t :-mail: 10u0 sy.ft ur less 4 T- - Each additional 500 sq.ft.or portion thereof - CC 13 no.: (Q��3 Flee hok. lic.no: (.. - Limited energy,residential 2 _ / e(to lic,no.: _ -City Limited energy,non-residential 2 —i+y+"��"' -_V - - Each manufactured home or modular dwelling Signal rr of supervising electrician(re uired) Dale Service andh it feeder 2 Sup.e'ecl.name(print) Licenaeno: Set's•icesorfeeders-Instellallnn, alteration or relocation: PIROPERINOWNER 200 amps or less 2 Name(print): 1`aI'v1 ` V S 201 amps to4(xlemps 2 -- `� -- -C -- -- Nlailing address: eI-t �y� 401 amps Io G00 amps 2 - � l'Cl_1 FAILS 601 amps to 1000 nmps _ 2 City: L �I;IIe: 7.111: Over IWO amps or volts 2 Phone: - Fax: E-mail: Recnnneoonl I Owner installation:The installation is heing made on property I own Temporary aervlcelorfeedera - which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocatlon: ORS 447,455,479, O 7 I 2(x1 amps or less —_-, 2 - 201 romps to 400 amps 2 Owner's si nature: Date: 3 ) "401 u,11+00 ams -- - 2- Branch cirenik•new,alteration, or cxtenslon per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Stoic: ZIP: v B. Fee for branch circuits without purchase - -- - - - of service or feeder fee,first branch circuit: 2 Phone:PhonFax: f? mail: -- Each edditio,al branch circuit PLAN REVIEW('Heaqv, cheel� nil 111311 j1pply) tic.(Ser tee or feeder not Included): UService over 225amps-avanu•rcia] Jficalibunclatiioy Fa ehp:,,,,patirrigation circle 2 U Service over 120 amps-nuingof 1&2 U Hazardous location Each!ignoroutlinelighting 2 familydweilings U Building over 10,(100 square feet four or Sigrdl circuit(%)or n limited energy panel, U Syslem over 600 volts nominal more residential units in one structure Aeration,orexlcmion• 2 UBuilding over thretstnries U Feeders,400 amps or more U Occupant load over y9 per om U Manufactured%tructures or RV park Each additional inspection over the allowable In any of the above: U Egres4lightingplan U Other: Per inspection _-- Submil sets of plans with any of the above. Investigation fee lire above are not applicable to temporary construction service, Other Not all jurisdictions accept credit carth,please call lurisdicrinn for mare Inf^mwtion Notice:This permit application Permit fee..................... __ r U Visa U MasterCard expires if n permit is not obtained Plan review(at _ %) $ _ Credit ears number: 4_ / /_ within 180 days alter it tins been State surcharge(8%)....$ � TOTAL . accepted as complete. ......................$ Arra^ CAff ^F�i Ids shown no ate it rAr�- S C'ardhalder signature Amount 44"V Ia oar.s,:st CITY O F I I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT M PLM2001-00360 11125 SW Hill Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08/15/2001 SITE ADDRL iS: 10677 SW LADY MARION DR PARCEL: 2S110DA•08100 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 042 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 CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES INC PRMT CTR 08/15/2001 $35.25 27200100000 1672 SW WILLAMETTE FALLS DRIVE 5PCT CTR 08/15/2001 $2.90 27206100000 WEST I-INN, OR 97068 Total $39.15 Phone 1: 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 rc gUlations 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 will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. 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: {t_f,_�, - (� Lam_ Perm!ttee Signature: J Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 7;2 -0V%V5 Plumbing Permit Application !Natereeived:_ �� DEm /• /(rpt e'4 ' City of Tigard Sewer permit no.: Building permit no.: Cwc(T!Tigard Addresb: 13125 5W Nell Blvd,Tigard,OR 97223 B Phone: (503) 639-4171 Project/appl no.. Expire date: Fax: (503) 598-1960 Dweissued: Receiptno.: Land use approval: _ case ale no.: Payment type Uy&t 2 family dwelling or accessory U Commercial/industrial O Multi-family 0 Tenant imprtrvement l�New construction U Addition/alteration/replacement O Foul service 0 Other:Dwz . Job address: /0CI�_S L i'. z 11 r. �.. 1 c 1.o on Fee ea. Tots! Bids, no,: Suue no.: New I-a -fuWy dweftgso y: Tax map/tax lot/accounr no.: (Includa100ft.for each etflltyccowt ion) -- SFR(1)bath Lot: Block: Subd±vision: `_- Sift )bath Project name: - SG ti �, �_`- ( )bath city/county: Gj� _ 1P: z Z Sac ad tiona7gath&itchen -� Description and location of work on premises:_F'Pn yrs/e lzs 151160 Mlaa: Catch basin/area drain Est.date of completion/inspection: v _15% eat lin trent drain - Manufactured home utilities Business name: � -0-,w-f-, - Manholes Address: Rain dmin connector . City: F�i-14 Sete C FIP: T 70 3 Sanitary sewer no.lin.ft.) Phone: ef- ',7o �.i' fFax:�' ,_ E-mail: Storm sewer no.Lin. t. — . Water service(no, ft,) , ~ O,CB no.: J17//�_ Plumb. ,us.reg. no. 5"y'y, �__v Fixture or Item: City metro lit o. -- ` - Abso tion valve _ Contractor's representative signature: /''- ack ow reventrr i Print name jz,a I nate; 'i/ / — Backwater valve Baan IAVatO^ _ Name: ,;t,,e 1l-c,/L,, Clothes w ra UishwasRer Address: 7;,7 - Dritking fourt.ain s) City: jss'' c«<: -^-- StataGg, ZIP: 0z_r __ B•ectors/sum Phone: a J' 6 j'c• e4-, Fax:�r 6,t E mail: x ens on tlutk -� Fixture/sewer ca Name ant,: ��� ocr sinkubub --�--- - Clarba It disposal _ Mailtng address: _ Hose bibb Cit -�� y State: LIP: Ice maker _ Phone. Fax: E-mail: nterceP�to-r�!grease-trate- Owner inutallationlresidential maintenance only: The actuel installation ime�s) y �� will be made by m6qeT nteuance and repair made by my regular Roof drain(commercial) employer on the p as per O?RS Ct pter 44',. ink(s),bes n(s , av sowner's si natureDate: LA um `- - hower%show'er pan Urinal Name: Water closet Address: __ - - � star heater City: _ State: ZlP__ _ ter: Phone: Fax- - -�E-mail _ Total Nat all juriadicdonr accept uedit cu&pleua•call juddirtlon for mon lnfnrmnilM. Minimum fee $ Notice This permit application Plan Irview (at `!;) $ U V144 O MaaarCarA expires if a permit is not obtained 9 crer.0 cid numbae --�- ,-!thin 190 days after it has been State surcharge(8%) ....$ huae of c Bch-order r i Dura nn r. it card accepted as complete. TOTAL .......................$ - _ 5 Cardholder Ii{nature `— Amour! _j a+naf,i(rNlxl:c't'�I n z o N a 0 C,1J rl r + � \ C ti. rD r r ~ ' "WA N a S i rDO~. n TT �p Olt r V '0 a O CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested_ ��" y AM PM _ BLD Location jgc6� 7-7 5 Suite r _ MEC _ Contact Person — Ph �� - 3 4' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC _ Retaining Wall A ELR Footing Access: - Foundation FPS _ Ftg Drain SGN — Crawl Dram Inspection Notes: Slab _—_— —- - SIT Post& Ream Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - -----_— ----.--- - Roof PART FAIL ----------- — - _ —�-_ PLUMBING Post&Beam -----� — - '""— - --- Under Slab Top Out —_ _ ----- ------------ Water Service Sanitary Sewer ----- ----�-`-' ---- — -- -- - Rain Drains - Final PASS PART FAIL -- —_-v--_-- —_ - _-- - MECHANICAL Post&Beam Rough In Gas Line —,—»�—^— — ------ — — ____ Smoke Clampers Final - ---------- ------ - -- -- PASS PART FAIL ELECTRICAL — SeNICe. Rough In UG/Slab - Low Voltage Fire Maim _— Final PASS PART FAIL SITE l3ackfill/Grading --- --- -- - -- - - Sanitary Sewer Storm Drain [ ] Reinspection fee of$_ — required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE -- ___ / [ J Unable to inspect-no access ADA i 1 Approach/Sidewalk Other Date _ `Y-- L - - Inspector _ < -' --- --- ------- Ext -- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION sr o 24-Heger Inspection Line: 639-4175 Business Line.- 639-4171 1 �t BUP _ Date Requested �! —�J— AM PM BLD Location `9Z c.-,., Suite MEC Contact Person Ph q 6 4�— 7 6 Z-f PLM Contractor Ph SWR BUILDING Tenant/Owner ELC — Retaining Wall ELR Footing Ac'ass. /� . Foundation �- <<'-� FPS Ftg Drain SGN Crawl Drain Inspertton Notes -- Slab — -- SIT Post& Beam - L-xi Sheath/Shear Int Sheath/E Clear J Framing Insulation Drywall Nailing _— ��xZ ti' 4/ — Firewall / -Firewall Fire Sprinkler --.-- __ Fire Alarm Susp'd Ceiling Roof Misc: ----- --- — — --- Final PASS PART FAIL -- ----- - _— _—. --_— PLUMBING Post ti Beam - -- - ----' —- ----- --- Under Slab Top Out -- - -- --- --- -- -- Water Service (Sanitary Sewer -- ---Rain ')rains Final -- - ----_— — _ --._ ------ PA FAIL rest m -- --- ----- ----- -- -�- .1.01LIgh In Gas Line ------- ----- --- ---- - — — Smoke Dampers F' — -- ------ — -- — — A t� PART FAIL ELECTRICAL ---- -- — — --- — `- -- Service -.---_—_------- ----- -- ------ --- Rough In UG/Slab Low Voltage - ---_----.—__— _ —_ — _— _ Fire Alarm Final -- ----- .—. —._- _ ------— ---- PASS PART FAIL SITE Backfill/Grading --- ---- ----- ---- ---------- �Sanitary Sewer Storm Drain [ ] Reinspection fee of$_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Rasin Fire Supply Line I ]Please call for reinspection RF __——_— [ ] Unable to inspect no access ADAAppro --�— OtherachlSidewalk Y Date �- ` Inspector — Other ��`_—�--- p Ext -- Final PASS PART FAIL j DO NOT REMOVE this inspection r,�-ord from the job site. Z_' CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- Date Paquested �! "�3 AM PM BLD Location UG % Sri L.G Oe Suite MEC Contact Pe,son _ Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC —� Retaining Wall ELR Footing Access. Foundation FPS _ Fig Drain Crawl Drain Inspection Notes- SGN S'ab _-- SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear Framing - — Insulation i Drywall Nailing /_�-�- �QBEL SP v,/C -��lie Firewall Fire Sprinkler � �_--��C L`/ Fire Alarm Susp'd Ceiling � /2 _42 0144.),Q-`I A11:2 _--- Roof Mise -_- PASS rAN 1 FAILPLUMBING L__ L Z Post& Beam -- -- ---- - -- - Under Slab Top Out J--- - - - `- -- Water Service Sanitary Sewer - ---- - - - - ----- Rain Drains Final ---- - - -� PASS FAIL -- �'_.l Post earn ----- -- -- -- ------- - Rough In '3as Line �- -- - --- --- - - --- - ------ Smok ampe Fina ---�-- --- ,--_.- - -- -- --- PASS ART FAIL Rough In -- ---- --- ---- ---- - --_-. UG/Slab Low Voltage ---------------_._. --- - --- --- Fire Alarm Finpl I'AS5 PART FAIL IX7 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 RE:_-___-_-- - _- [ ]Unable to inspect-no access ADA Approach/Sidewalk Other DateVIz _ Inspector �� — --Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.