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10733 SW LADY MARION DRIVE y. 7-0 //(, /0 / ELE S 89053'03" W 65.00' as 4<8 401 W t4)12 77,0U NmC EaDNc 7S. W SU�IIE��I,I�t "�ExTEAIOA memo" 3 (D �n� o 6.00' - 3q r, a 21. O' V 10.50' I t � t � I 7.00' ' 3 FF I w I 7 .0 CO w N �, i- --_____� o N w UI I w QC I , 0 L MS ---cl 3�l 0 o .n z w 6.00 0 T2. 2' 22.00Ln 5.0, FN I '`y . o '2.92 5.0V 3/4 - N o sub ELL rARAOL k F._ _ 3412.. N 89052'07" E 65.00' 312. < N > EROWN CONTROL t.pRaVIDE 8 MAWPJN Ir(9*)THICK S. W. LADY MARION DRIVE GRAVEL PAD&DRIVE UNTL PEWNENI CONCRETE DRIVE IS IN PLACE. — — — —. — — — —. _ _-- .-- 2 P�YDE•MNNTAMI SCS 7 fC�EAS 00M. I SCALE DRAWING LOT 44 ERICKSON HEIGHTS S.E. 1 /4 SEC. 10, T.2S., R.1 W., W.M. JOISS SIAJ 1.APY MAP40N 09 . CITY OF TI GARD W, SHINGTON COUNTY, OREGON --A 2.50 FOOT LANDSCAPE EASEMENT SHALL_ I DECEMBER 14, 2000 Centerline Con cep is Inc . EXIST ALONG ALL STREET FRONTAGE. DRAWN BY: MPW CHECKED BY: WGDIII --A 7.50 FOOT UTILITY EASEMENT SHALL SCALE 1 "=20' ACCOUNT 115 EMAIL WWW.CCIEMAILC�HEVANET.COM EXIST ALONG THE 2.50' LANDSCAPE EA.SEN.IcNT. 640 82nd Drive Gladstone, Oregon 97027 M: \MI_I\L44ERIC;K 503 650-0188 fax 503 650--0189 1 i9 . _.._ ---........r► .r+.......-----.w�-._.� ...�... ...� � � . �,n.,,m�t�s '��Y' v r�k 5 '�C:BfERlAW�716'M�+R�xMrp+�+ F i - r�n . :.-:.rF .,,r,r ca� >nw, 'WgAA. :. ,Y;�R ..,.,- .� ...,.,�eiravw:. �,.,ruA�+muor M., " .._ me.�i 'rr.G,�.•Jra� ..cry .. �. ,... _ �,�.�. NOTICE: IF 'THE PRINT OR TYPE ON ANY � � Ir � I � I � II II � I � I � � I � Ir �� II .IrI � IIIII � r IfTfF]T .rf.�. rFj1 � I1 .1� I � 1_f .L.l_1 L11., .L1 �. .� � 1 1fI _L_I_� _� _i .I � � r� 1 1 -111-1T-1 11F T]T- T-11 1 iIC .I �r 1� I � l� I f � L_ I�I 111IIII i � I iIi I � I � I I I i 1 I 1 I f I IMAGE IS NOT AS CLEAR AS THIS NOTICE, — 1 _ zI 3 _� �7► IT IS DUE TO THE QUALITY OF THE _ _ _ No.36 �� 'w; • ORIGINAL DOCIJMF_NT 09 E Z ; t 1 I lI� �� illi ��. ILII �� IIII�IIII ILII Illi 11 11. 1111 11� Ill illi. 1111 1111 1111 ILII ILII ILII ILII ILII 1111 ILII ILII .VIII ILII 1111.1111 III ILII 1111 illi ILII ILLI 11111 ill Ill 1111 111 1.111 .�.11.l.l.ad1111�1�i1 l I J: Q W W N r w CL 3 1 O v 10733 SW Lady Marion Drive CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ 111-10- Date Requeste'cl� AM PM � BLD Locat_ion, ! L 1�.1 Mq&Q Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes SGN Slab - -. - _ SIT Post R Beam Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Zoof Misc - - _ ----- --- Final - PA AT FAIL -----_- ----_-.- - - L Post& Beam ---- -- _- --` Under Slab Top Out Water Service Sanitary Sewer R ins PART FAIL Past& Beam -- ---- -- Rough In Gas Line - -- - Smoke Dampers Final - ----- - - - ----- -- PASS 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$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE -_ - _ -_ [ ]Unable to inspect-no access ADA r Approach/Sidewalk Date �G' �' Inspector__ � Ext Other - ----1—.—_--L_-__ P —__—�'S__..____-- ----- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested_ AM PM BLD Location. ZQ'23 5<<-, Suite MEC Contact Person _ Ph � y -3� z__ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes: — - -- Slab — SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing >i ia:2 — Insulation Drywall Nailing Firewall Fire Sprinkler Fir-,Alarm Susp'd Ceiling -- Roof Misc: -- Final PASS PART FAIL -- PLUMBING Post& Beam --- Under Slab Top Out Water Service Sanitary Sewer -- --------� ---------_--- Rain Drains Final -- — —_-- — PAS' PART FAIL C,. Pos;a Beam ---- — — -- --- -- Rough In Gas Line ------- --- --_——-- —— Smoke Dampers PART FA\_'L ELECTRICAL -- ` - --- — Service Rough In »__..r— _—.—_—.----- ---- --- -- UG/Slab Low Voltage -- -------- -------- — --- Fire Alarm Final PASS PART FAIL _--------------.--_—_--- ------ _-- -- --- SITE Backfill/Grading — Sanitary Sewer Storm Drain [ ] Reinspection fee of$ _-- _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RIF A Unable to inspect-no access ADA Approach/Sidewalk Other Date i i _ Inspector— Ext Final PASS PART____FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP __Date Requested �' L� AM PM BLD Location_/ U 7 3,� -5,, Suite q _ MEC — Contact Person Ph 7, PLM Contractor Ph SWR UI Tenant/Owner ELC _— Retaining Wall ELR —_.- Footing Access: Foundation FPS Fig 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 Fin AS PART FAIL -- - ----- ----- -- -- - --- '13 LUMBING --- ------ --- ---- Post& Beam - Under Slab ------ - ---- - ------- Top Out WaLyr Service Sanitary Sewer -- --� --- --------- Rain Drains Final PASS PART FAIL ----- MECHANICAL Post & Beam ----- ____ -_- -._-_-- ------ - Rough In Gas Line ------- -- -- --- --- -- Smoke Dampers Final -_.---- --- --- ---- -- PASS PART FAIL ELECTRICAL --- - --- ---------------- — — ----.—._--_ Service ---- Rough In UG/Slat _`_ -_. -------- - Low Voltage Fire Alarm - _�-_ - -.- - --- ----- - Final PASS PART FAIL ------ SITE _ Backfill/Grading ------- — Sanitary Sewer Storm Drain ( i Reinspection fee of$ required before next inspection 'flay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call for reinspection RE:--_` _—_ ( )Unable to inspect- no access ADA Approach/Sidewalk Other nate p L Inspector Ext -� ---- _ _-- Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. w o ; "Ti i z CL S f7 _ R \ J W rM 01 �o off, 0 J V u .1. I� CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested �AfV! PM BLD _ Location Zl� -56-1 L-G� iyl4��,.. Suite MEC —_ Contact Person — Ph PLM Contractor _ Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR _ Footing Access: v — Foundation FPS Ftg Drain -- Crawl Drain Inspection Notes: SGN — Slab _ _ SIT Post-& Beam Ext Sheath/Shear Int Sheath/Shear Framing ------ - --- — -- — Insulation Drywall Nailing Firewall Fire Sprinkler —__.— Fire Alarm Susp'd Ceiling ____---- Roof Misc _— Final — PASS PART FAIL PLUMBING —-- — -- Post& Beam —`— Under Slab �_- Top Out - --------- _ — Water Service Sanitary Sewer ----- — Pain Drains Final — - -- PASS PART FAIL MECHANICAL --voor Post& Beam ---- — --- Rough In Gas Line — Smoke Dampers Final - --- - -- — --- - PAS PART FAIL ice - --- --------_.-. ---------- -.-- .� _ Rough In UG/Slab Low Voltage —�— Alarm ----- - --------- i PASS ART FAIL �- -------- - — - -------- ---- Backfill/Grading _-- Sanitary Sewer Storm Drain ( I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( j,lease call for reinspection RE:_____-____--_-. [ Unable to inspect-no access Fire Supply Cine ADA Approach/Sidewalk Other Date li' /_� / Inspector_ L� !/ � _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT M PLM2001-00362 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08/15/2001 SITE ADDRESS: 10733 SW LADY MARION DR PARCEL: 2S110DA-08300 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 044 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 (NATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. FEES Owner: Type By Date Amount Receipt REN4ISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 27200100000 1672 SW WILLAMETTE FALLS DR 5PCT CTrt 08/15/2001 $2.90 27200100000 WEST LINN, OR 97068 Total $39.15 Phone 1: 503-557-8000 Contractor: MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPF ^.TIONS 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 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 Noti`ication 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: �, , �X'2 10— le-"" A .L T_ Permittee Sign^cure: J 1 C( 4,k ,� Call (503) 639-4175 by 7:013 P.M. for an inspection needed the next business day x6iii�� Plumbing Permit Application Datereceived: J12-101 Permit no.iPJA /-.0,q3 Ai� City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Gall Blvd,Tigard,OR 97221 City of77gard Phone: (503) 639-4171 Project/appl.no.. Expire date: Fax: (503) 598-1960 Date issued: By;etj6j Receipt no.: Land use approval: Case file no.: Pavment type: TYPE OF PftMl*f U'�.jI & 2 family dwelling or accessary U('cmrmcrcial/incJustnal U Multi-family U Tenant improvement LI New construction U Adclitian/;tirc.rariu 1/ntplacx rnent U Food service U 00her: 1 Job address: ,r Descri tion Q(y. 1Fee(ea.) 'total Bldg.no.: _ Su no.: tom- -- New I-and 2-famlly dwellings only: -- -- — (Includes 100 it.for each utility connection) Tax map/tax lOt/aCCOUnt HO.: SFR(1)bath -- - Lot: Block: Subdivision: - - -- - --- -- --- — -- _ -- 3FR(2)bath Project name: _ SFR(3)bath �- - -- City/cocnty: l ZIP: — z z1 - Each additional balhlkitchen- — ----- -- Description and Ideation of work on premises:—49 n,A, 7—X, Site utilities: Catch basin/area drain Est.date of completion/ins�-z-tion: Dryweils/feach line/trench drain Fooling drain(no.lin.ft.) PLUMBING CON1111ACTOR Manufactured home utilities Business name:, j,. /'n' �ti�, Manholes _ Address: .v, 1 r /_IT— ' Rain drain connector City:FS', 'u� State:(] Z1P: 97G'2� Sanitary sewer(no.lin.ft.) Phone: oP ,?c� t x Fax:ry.,rt E-mail: Storni sewer(no.lin,ft.) Plumb.bus.re no: 5-V'73 _ Water service(no. lin. ft.) CCB no.:ll7 � B• City/metro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve _- / �1'. Date 7 i'i i,� Back flow preventer Print name: I , r Backwater valve I ION Fd ME 61 PIN 1§011111Basins/lavatory r ' l (-�WAShef Name �l ,,C z r!� a!L _ Dishwasher Address: f c' 7/3 _ _ — Drinking fountain(s) City: c Statec,/. ZIP o Z� Ejectors/sump Phone: t �JC, I'ax t• r Email: Expansion tank -- Fixture/sewer cap _ Natne(print): a, 1 alm—MU14 Floor drains/floor sinks/hub R ` ?Mailin address �Ol Garbage disposal • [lose bihb City: Ll �0_ State ZIP: he maker Phone. Fax: E-mail: Interce�itor grease Uap Owner installation/residential maintenance only: The actual in.1 tiiation Pfimer(s) _ will he made by m6vti intenance and repair made by my regular Roof drain(commercial) employee on die pI w i as per URS CI pier 447. Sink(s), asin(s), ays(s) Owner's signaturef)ale: ' r' Suttip - fubs/shower/shower pan - Name: Urinal — - Address:-- -- - - -- --- ------ --- -- Waler closet -- - W ater heater City: - State: ZIP: Other: — Phone: Fax_ E-mail: Total Neu all jurisdictions accept credit cards,phase call jurisdiction for more information. til.ttice•This permit application Minimum fee............. r U Vct,a U MaxtetCard expires if a pemlit is not obtained Plan review(at #) $ _. Credit card number:— -- L -� within Igo days after it has been State surcharge(R46)....$ - _ Expires TOTAL • $ None of cattlholder s shown on credit card accepted as complete. S C4rdholder signature Amount 440-4616(6mOn'anl) CITY OF TIGARD MASTER PERMIT PERMIT#: MST2001.00014 DEVELOPMENT SERVICES DATE ISSUED: 02/01/2001 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10733 SW LADY MARION DR PARCEL: 2S110DA-08300 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 044 JURISDICTION: TIG REMARKS: New SF deta'„hed dwelling. path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS RF7UIRE0 CLASS OF WORK NFW HEIGHT: 23 FIRST: t,r,45 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,528 of GARAGE: ill of FRONT: 20 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: o/ RIGHT: 5 VALUE. b 241.0,,00 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3.174 00 of REAR: 43 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: too SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS I WATER LINES: 1nu BCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<10OK: 1301L/CMP<3HP'. VENT FANS: 5 CLOTHES DRYER: 1 ,,AS FURN>-TOOK: 1 UNIT HEATERS: HOODS: t OTHER UNITS: I MAX INPt btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER tEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp. 0 200 amp'. WISVC OR FDR: I PIIMPIIRRIGATION: PER INSPECTION. EA ADD'L 500SF: 5 201 400 amp201 400 amp. isl WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 101 - 600 amp: 401 - 600 amp: EA ADDL BR CIR. SIGNALIPANEL: IN PLANT: MANU HM/SVCIFDR: 401 • 1000 amp'. 601+amps-1000v. MINOR LABEL 1000-amplvolt: PLAN REVIEW SECTION Reconnect only- >=4 RES UNITS SVC/FDR-225 A >600 V NOMINAL: CLS AREAISPC OCC: .- ELECTRICAL-RESTRICTED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEk9O: x VACUUM SYSTEM. AUDIO&STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNt'r,C LT: BURGLAR ALARM. w OTH. BOILER: HVAC, LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: x DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS: TOTAL FEES: $ 7,205.83 Owner: Contractor: This permit is subject to the regulations contained in the RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code,State of OR Specialty Cedes and 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work will be done in WEST LINN,OR 9 7068 WEST LINN,OR 97068 :accordance with approved plans This permit will expired work is not started within 180 days of issuance,or if tha work is suspended for more than 180 days ATTENTION Phone. Phone: Uley:;^Iqw requires you to follow rules adopted by the Oregon UbI ty Notification Center Those rules are set Rea N HC 4'r09", 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)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr Electrical Service Low Voltage Water Line Insp Final inspection I'ost/Bearn Structural PLMiUnderfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Issued By : _ II �- Permittee Signature : tl (50 ) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00012 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02/01/2001 PARCEL: 2S110DA-08300 SITE ADDRESS; 10733 SW LADY MARION DR SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 044 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS 01-WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: FEES RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR WEST LINN, OR 97068 PRMT CTR 02/01/2001 $2,300.00 27200100000 INSP CTR 02/01/200' $35.00 27200100000 Phone: 503-557-8000 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection 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 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 Notificatior 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 caking (503) 246-1987 Issued by: Permittee Signa`.ure: -- - - Call (50 11) 639-4175 by 7:00 P.M. for an inspection needed the next business day 05 r Building Perinit Application Datereceived: / Permit no.: City of 'Tigard D rm Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl no.: -- F.xpiredate: CiryuJ1'igard Y� Receiptno.:Date issued: B Phone: (503) 639-4171 _ Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: / 1&2 family:Simple Complcx: K1 8'2 family dwelling or accessory U Commercial/industrial U Multi-lancily `ioew construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: _ 1 INFORMATION Job address: Bldg.no.: Suite no.: --- - - Lot: Black: suh;'_,vision: V 411IN—ftl"t � Tax_map/tax lot/account no.: _ Project name: _ Description and location of work on premises/special conditions: 1 1 1 Name: F-E A.166ANG Mailing address: - `�^ h/t PALL 1 &2 fancily dwelling: ---- - - City: sli le. 711'. A1064Cp I Valuation of work .. 'b 1 Phone: i',u E-mail: No.of bedrooms/baths...............I................. -- n --- �• 2-- Owner's representatv : ayP - Total number of floors................................. ['hone: _ New dwelling area(sq. ft.) ...................I...... APPLICANT Gare e/cori area(sq.ft. Name: Covered porch area(sq. ft.) ......................... Mailing nti�lrrss: Deck arca(sq. ft.) .............................. ........ II — Other strucucre areas ft. City: _ State: ZIP: ( q. )............. Phone: F,tti— E-mail: - CornmerciaIli itdustHAI/nuhl-fitmilil•: - 1 1 Valuation of work........................................ 'I Business name: Existing bldg.area(sq. ft.) .......................... — - Address: New bldg.area(sq. ft.) ................................ City: _ State: ZIP: Number of stories........................................ Phone: Fax: E-mail: Type of construction.................................... _ CCB no.: gmup(s): Existing: - --- ---- __ New: City/metro lic.no.: Notice:All contractors and subrontrac ors are required to be I licensed with the Oregon Construction Contractors Board under Name: ��, � Vit?. provisions of ORS 701 and may be required to be licensed in the Address: �� jurisdiction wher'-work is being performed. If the arplicant is —i-s , exempt from licensing,the following reason applies: Cit — _ State: 7,11: Contact pelsnn: Plan no.: Phone: -01 1'ax mail:Wk$W. - I Name: C-6A Contact person: (�k_R� Fees due upon a,,plicalion ........................... $,_ Address: Z Late received: City: '��, NQ State 7.IP: a ZIVAmount received ......................................... $ Phone: • �- F a�21,b�04"1 E-mail: Please refer to fee schedule. _ hereby certify I have read and exarili-d this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more Information attached checklist.All Pkilvisions of laws and ordinances governing this U visa o Mastercard work will be complie +% t whether specified herein or not. /� Credit card number -- - -- — -- 'fr I Czplrca Authorized SI nalp Ure:� �� Date: � Name nr cerdhol c u shown on credit card ,�i,'wI1G Y s Print name: Cardholder signature Amount Nolice:"this permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 4104613(6MCor,t) 000 Mechanical Permit Application Date received: 4, Q/ Permit noY�l 7, City of Tigard project/appl.no.: Expirednte: ( „� i;,,,,, , Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By-.tff Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: TWE OF PERMIT )<I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant impr vement XNew construction U Addi(ion/alteration/replacement U Other: COMMERCIALJOB SITE INFORMATION Job address- jolSy ��( J►19A1.IA�1_ rL. Indicate equipmentquantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax Iot/accounl no.: profit. Value$ Lot: _ Block: ISubdivisionW_fj9 141S•_ 'See checklist for important application information and Project name: jurisdiction's fie. schedule for residential petmit fee. !: City/county: ZIP: I ' Description and location of work on premises: Fee(ea.) '10181 Est.date of completion/inspection: Dewri tionQty. Rea•onl Res.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit ---,CFM---,--- Is existin c ace insulated?U Yes U No Aircon itioning(siteT required) T - g•P Alteration of existing HVAC system 'MECHANICAL CONTRACtOR of er compressors Business name: (� N state boiler permit no.: --- - - _ !1P Tons BTU/H _ Address:'L -�- ir L"P Fire/smoke amper uct:..noke detectors City: 1941t1,�j Q�Q, Slate: ZIP: � ffeat pum- p(she on regwre ) _ Phun Z Fax: G-mail: nstal rep acefurnac wrner_^ 't'B no. Including ductwork/vent liner U Yes U No OI nstall/replace/relocate heaters-suspended, , t t y/metro lic.no.: wall,or floor mounted N;n»r i plea w print I' Vent fora hance other than furnace CONPrACT PERSON Refirigernilion: Absorption units BTU/H Chillers _ Hp _ -- Address: Compressors HP - :nv rnnmenla ex ust an vent a1 on: City: State: ZIP: Appliance vent Phonc: Fax: E-mail: I Dryercxhaust Hoods, -- Type res. rte en azmat - hood fire suppression system Name: _��j�aM�X.�. _ Exhaust fan with single duct(bath fans) Mailing address , - M. _ -x laust system�.aQart from heatingor C City. �l1/ (� N State„- Z1P: � lb ucT-Tplhfn�as"'""""'ul on(up to outlets) ---- �Iype. LI'G _ NG Oil Phon 7. Fa !:-nwil Fuel i in cache citiona over4ouslels - - roeesspiping(se ematicrequire ) Nartle: r.5 Number of outlets - --- -�- - -- Other ste ne app ae or equ pmenl: — Address: SLI W 4 Decorative fireplace t'ity: P __ Slate: _Z.IP: Aj nsert-type Pho w 'a E-mail: -V'oodqtove/pel let stove Ul'lcr. Applicant's signature: -----• Datc: _ Ower: Name (print): Uq - --- ,-- Not all puisdlcaans accept credit cants,plense c_,t iurimlictian for more Inlormetion. Per»it fee.....................$ Notice:This permit application U Visa O MnatcrCnrct Minimum fee................$ expires if a permit is not obtained , Credit yard number: Plan reVICW(at %) ,Ti zpin.— within 180 days after it has been State surcharge(8%) ....$ Name of cardhalder nil shown on credit card — accepted as complete. Cardholder signature ^--� --— Amount 410 4617(6KIWOM) -r�tJJ Z00/- 0 2 1'111111bi11g Permit Application Datercccwed: //` D Permit no.: ��(� " City of Tigard PIS Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: C`I"'/11f:ofd Phone: (503) 639-4171 ProjecUnppl.no.: Expiredate: Fax: (503) 598-1960 Date issued: By;Z/ I Receipt no.: Land use approval: Case lite;o.: Payment type: I &2 family dwelling or accessory U Commercial/industrial U Multi-family O Tenant improvement ew construction U Addition/alteration/replacement U Food servic, U Other: Job address: I)escriptiorl Qty. -Fee(ea.) Total Bldg. nn_cT— Suite no.: New I-and 2-farnily dwellings only: Tax map/tax lot/accountno.: -- kincludr -sltltlft.foreachutilitvconnection► ----- Block: SFR(1)bath Subdivision: SFR(2)bath --- Project name — SFR(3)bath -- — —-.-- City/county: p ZIP: Each additional bath/kitchen - -- Description and Iocabm, ..f a rrk om premises: siteutiiitier: 4_�1� 1X��I _1 ILY_ �_-, Catch basin/area drain Est.date of conpletion/inspection: Drywells/leach line/trcnch drain --- PLUMBING 1 1 Footing drain(no.lin. ft.) � p�T�� pV Manufactured home utilities Business n;!n)e:` v Manholes - Addre:,s: If% W tM �� Rain drain connector City State: ZIP: q'� Sanitary sewer(no.lin.ft,) - - Phone: Fax E•mvl; Storm sewer(no.lin. ft.) CCB no.: 101&&(0 _ Plumb.bus,reg.no: Water service(no.lin. ft.) - City/metro lic.no.: - - " Fixture or item: Contractor's representative signature: Absorption valve ---- Back flow preventer T - Print name: - h:Itt' Backwater valve - C.ONTACT PERSONBasinsflavatory _Nalnc. ?EM E FAA, Clothes washer Dishwasher Address: � --- ----- ---- - - Drinking fountains) — City: State: ^"LIPSEjectors/sump �! :�� I?-mail• -- Expan phone- tank _ Fixture/sewer ca N;une (pnnl): — r- ,E- Floor drains/floorsinks/hub -- --- (3arba a disposal Mailing address: L IW WIL�'N�• € -��""�-- Hose bib City:141W titatc: lll'. - -N — - �.1Q�,L Ice maker _ Phone: Fa E-mail: ..— Interceptor/grease trap 7 Owner insu,llation/residential maintenance only: The actual installation Primer(s) will be made by me or dke maintenance and repair made by my regular Roof drain(commercial) rt-- employee on the propr y wn as per ORS Chapter 447. Sin (s),basin(s),lays(s) — Owner's Signa,.ure: , _ Date: Sump Tubs/shower/s ower an Name: 66A Urinal Water closet Address: V -6W Water heater - - City: StateZIP: I '�'Zr7 Other: _ - Phon Mp E-riail: Total Nd art jurist'clions accept credit cards,please CPA jurisdiction for more inrorrinnion. Minimum fee................ Notice:This permit application . - -- - Cl visa U blaster{a d Plan review(at _ %) $ Credit card number Expires .expires If a permit 13 not nblalnCd -------- s Irca within I RO days ager it has been State surcftarg (8%) ....$ _ r Name of cardholder as shown on credit—cad — accepted as complete. TOTAL• ......... .............$ Car holder signature Amnunl 44114616(601rt:OM) Electrical Permit Application Datercccived: 7Paymen(type: ;�J�fp�f/.OUD26MA11M ity of TigardProjecVappl.no.:City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ecejptno.:Phone: (503) 639-4171 Fax: (503) 598.1960 Case file no.: Land use approval: FYPE OF PEIRM IT &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant impmveu,,^nt ew construction U Addition/alteration/replacement U O(her: U Partial — M163 Jab address: IQ ?` ctj W,J Bldg mw.: LI;uilc no.: lax rnaphax lot/accoum no.: Lot: Block: _ Subdivision: �Lik�.�ll�►J _ — Project name: IDescription and lo;ation of work on premises: dbI -� � Estimated flste of completion/inspection: Job no: --, fee Max Business name; Description ptv. G (est.) Total no.lnsp —— New reshlrntial-single or multi family per Address: dwelling unit.Includes attacised garage. City: L "ff2 -- State: Servlceincluded: Phone: •�iL�1� Fax�7.5V1 E-mail: 1100 sy (t.or less _ n Ep;h additional 500 sy.ft.or portion t'te—I CCB no.: Q L'Iec.bus.lic_no� G1�!S _ - -- Limited energy,residential 2 Cit /metro lie.no.: _ Limited energy,non-rcsidemial — 2 Each manufactured home or mndular dwelling Signature of supervising electrie_an(required) Dale Service ancuor feecle• 2 Sup,elect narne(print) License no: Services or feeders—Installation, alteration or relocation: 200 amps or less 2 Name(print): G(j' 1C1.� 201 amps to 400 amps 2 �r� l 401 amps to 6(10 amps 2— Mailing address: 1, `(/(,� 1 • 601 amps In I1)0(1 ramps 2 Cit ' Stale:PLI 7.1 P:4110joillb Over 1000 amps or volts z" PI()It, Fa E-mail: Reconnertmdy _ —` 1 (honer installation:The installation is being made on property I own Temporary services or feeder.- which is not intended for sale,lease,rent,or exchange according to histallatlon,alteration,orrelocation: ORS 447,455,479,6 1. 200 amps or Icss I 2 0 I 201 amps to 400 amps - 2 Owner's signature: Dale: -- -----.—.-_....._____-- —_-- — 401 to 600 snips 2 [Mom 101 Branch circuls-new,atter tion, or extension per panel: Name: L A. Fee for branch circuits with purchnse of Address: service or feeder fee,each branch circuit 2 Clly: � State:^I ZIP: B. Fee for branch circuits without purchase of service or feeder fee,first hnanch circuit: Phone. —. Each additional branch circuit: YLAN c Misc.(Service m frrder not Included): OServiceOver 225amps-commercial UHedlth-camfociltiv Fachpump orinitiation circi^- 2 U Service over320amps-toting of 1&2 U Hazardouslocaunn Loch sign or outlinelighting 2 family dwellings U Budding over Moot)square feet four or Signal circuit(s)nr 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,400 amps or more •Ikscri tion:_ --__ — --- U Occupant Inad over 99 persons U Manufactured structures or RV park Foch addlrhnal Inspection over the allowable In any of the above: U FgmWlightingplall U Other: Pcrinspection Rubmif__a efs of fans wlfh an of the slave. —--- r p r Investigation The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cants,please can jurisdiction raw mom inrmmation. Nntice:This pennit application Permit fee.....................$ _ U Visa U MasterCard expires if n permit is not obtained Plan review(nl _ %) $ rtedu earl mmdur _ within 180 days after it has been Stale surcharge(8%)....$ _ Lspir s accepted as complete. TOTAL .......................$ — — Name of cardho rk•ss shown on credit card S Cardholder signature---- Amrnmu ----""'— 440 4615(fJ(xUr'UM CITY OF TIGARD 1312° S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GAGE ENTERPRISES INC PO BOX 1429 CLACK,AMAS, OR 97015-1429 Electrical Signature Form Permit #: MST2001-00014 Date issued: 02101120E Parcel: 2S110DA-08300 Site Address: 10733 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 044 Jurisdiction: TIG Zoning: R-3.5 Remarks: New SF detached dwelling. 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. 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 GAGE ENTERPRISES !NC 1672 SW WILLAMETTE FALLS L R PO BOX 1429 WEST LINN, OR 97066 CLACKAMAS, OR 97015-1429 Phone #: 503-557-8000 Phone #: 503-657-0142 Req #: sLP 6185 LIC 34544 ELE 3-128C AN INK SIGNATURE IS REQUIRED ON THIS FORM A Signature of ;+upervising EleOTtrician 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#: MST2001-00014 Date Issued: 0210112001 Parcel: 2S110DA-08300 Site Address: 10733 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 044 Jurisdiction. TIG Zoning: R-3.5 Remarks: New SF detached dwelling. path 1 der Your company has been indicated as the plumbing roniracofor fromr olurncdicated above. In ompany sign belowrandf for the plumbing permit to be valid, please have the appropriate individualY rn 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 completed form is received OWNER: PLUMBING CONTRACTOR: RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC 1672 SW WILLAMETTE FALLS DR '736 SW NIMBUS AVE WEST LINN, OR 97068 BEP/ERTON, OR 97008 Phone #: 503-557-8000 Phone #: 644-8698 Reg #: 1 Ir 79566 PI M 20-148PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized 'lumber if you have any questions, pease call (503) 639-4171, ext. # 310