12279 SW LANSDOWNE LANE 1.
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12279 SW Lansdowne Lane
CITY OF TIGARD MASTER PERMIT
PERMIT#: MST2001-00447
DEVELOPMENT SERVICES DATE ISSUED: 8/28/01
13125 SW Ha l Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDREGS: 12279 SW LANSDOWNE LN PARCEL: 2S10313C-08200
SUBDIVISI^N: MLP1999-00005 MnSES P11_U00-077 ZONING: R-4.5
BLOCK: LOT: rj2 JURISDICTI:,N: TIG
REMARKS: C:onstructio^ olew :tingle f<lmily detached residence. Path 1
BUILDING
REISSUE: v srr) +v FLOOR AREAS REQUIRED SETBACKS P.—WIRED
CLASS OF WORK: NL Y/ H ,HT: 2h FIRST: 1.54' at BASEMENT: of LEFT: 8 SMOKE DETEC TORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND 1.954 at GARAGE. 734 of FRONT: 20 PARKING SPACES: 7
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: of RIGHT: 8
VALUE: $3'08,40320
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3.19500 at REAR: 29
PLUMBING
SINKb I WATER CLOSETS: 3 WASHING MACH. 1 LtWNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
' LAVATORIF:S: , DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWEItS: GARBAGE 01—. 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUE'.TYPES FURN<t00K BOIUCMP<314P: VENT FANS: 5 CLOTHES DRYER'
GAS FURN—100K: 1 UNIT HEATERS: HOODS: 1 OTHEt.UNITS: 1
MAX;AP: blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
_ ELECTRICAL
_AL'SIDENTIAL UNIT SERVICE FEEDER 1EMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS _
100)SF OR LESS: 1 0 - 200 amp: 1 0 200 amp: 1 WISVC OR FOR: t PUMPARRIGATION: PER INSPECTION:
EN ADD'L 500SF: 8 201 - 400 amp: 201 400 amp: tet WIU SVCIFDR: 00 SIGNiOUT LIN LT: PER HOI'7:
L,MITED L'NERGY: 401 000 amp: 401 • !j0 amp' EA ADDL OR CIR: SIGNAUPANFL: IN PLAN*
'AANU HMISVCIFDR: 801 • 1'100 emu: 001+ampn1000v: (AINOR LABEL:
1000+amplvolt:
PLAN REVIEW SECTION
Roconnact only: ---
> 4 RES UNITS: SVC/FDR>•225 A.: y$00 v%JN,NAL: CLS AREA/SPC OCC.
_ ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO A STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: MVAC. LANDSCAPE/IRRIG: PROTECTIVE SIGNL'
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC DATA/TELE COMM: NURSE,ALLS TOTAL 0 SYSTEMS:
Owner: Contrat,or: TOTAL FEES: $ 8,381.59
WHITFORD SCOTT LLC W HITFORD/SCOTT This permit i s sl bject to tie regulations contained in the
BLVD h5#381 4888 NW BETHANY BLVD. Tigard M,.,;.-tpal Code,State of OR Specialty Codes and
4888 NW BETHANY
PORTLAND,OR all other applicable laws. All work will be done In
97 BLVD 80 K5#381
PORTLAND„OR 97229 accordance with Jpproved plans, This permit will expire if
work is not started within 180 days of Issuance,or if the
work is suspended for more than 1.,on days. ATTENTION.
Phoma Phone: Oregon law requires you to folljw rules adopted by the
Oregon Utility Notification Center. Those nllera are set
Rag N: LIC 107990 forth in OAR 952-001-00101.6rough 952-001.0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)2246-1987.
NEQUIRED INSPECTIONS
Erosion Cnntrol Insp 8' Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain It sp Plumb Final
Sewer Inspection Underflowr inr,,'-:Ion Plumb Top Out Exterior Sheathing Insl Water Line 1gp Final inspection
Footing Insp Crawl Drain/?ackwater Electrical Service Low V)Itage Appr/Sdwlk Insp
Foundatlon Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Electrical sinal
Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Mechanl,al Fin?!
Issued By Permittee Signature
Call (5031639-4175 by 7:00 p.m. for an inspection needed �:he next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT'#: S28/01 00226
D TE ISSUED: 8(2.8101
13125 SW Hal' Blvd., Tigard, OR 97223 (50) 639-4171
PARCEL: 2S103BC-08200
SITE ADDRESS; 12:279 SW LANSDOWNE LN
SUBDIVISION: NjL.P1999 30005 MOSES PP2000-077 ZONING: R-4.5
BLOCK: LOT: 002 -,JURISDICTION: TIG
TENANT NAME,
USA NO: FIXTURE UNIT`i:
CLASS OF WORK. NEW L`WELLING UNIT',: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSb"J^. IMPk-RV SURFACE:
Remarks: Sewer connection for new single family detached residence.
OwaPr: _ FEES
WHITFORD SCO- I' LLC Type By Date Amount Receipt
4888 NW BETF-'AP Y BLVD K5#331 PORTUWD, OR X7229-9260 PRMT CTR 8/28101 $2,300.00 27200100000
R\ISP CTR 8/28/01 $35.00 21200100000
Phone: 503-533-2255 Total $2,335.00
Contractor: _
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply v.,th all ine rules and regulations of the Unified Sewage Agency. The permit expires 180
il: will be forfeited if the permit expires. The Agency does not guarantee
days from the date issued rhe total amount pa
the accuracy of the side sewer laterals. If the sewer is not located at thi measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not s, located,the Ostaller shall purchase a"Tap and Side Sewer" Perm
Issued by: c , _ _ _ Permittee Sigrraturo:
�,�.t =s+
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
_5,�i� �r�/- oc�•
Building Permit Application b
�Daier,,-iv,d: r , Permit no.:rJ<,-� e/, v..City cif Tigard -
Address: 13125 SW ifall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
Phone: (503) 6.49-4171 Date issued: 13y: Receipt no.:
Pax. (503) 598-1960 Case file no.: Payment type: -
Land use approval: �4 >/99p-aooa S / I&2 family:Simple Complex:'I VPE PERM 11'
(` �
t,
U I &2 family dwelling;or accessory U Commercial/industrial U Multifamily XNe" construction J 0enuduioll
U ldalitiou/altrrattiort/rcplacemert U Tenant improvement U Fire sptinl,l(Walarnl U Uthcr:
Job address: Bldg.no.: Suite no.:
Lot: '�� Block: Subdivision: 'i'ax map/tax Iol/accouni no.: ?i
Project name: _ — 1 rM —e leeT
Description and location of work on premises/special conditions:
Nam!: +
Moiling address: _( ;?T144aN 1 r �► 1 &2 tingly dwelling: �??
City: - State• zi .� Valuation of work.......a.?.Q. . t{U 3
Phone: - ax: - -mall: vo.of rxdrooms/haths.........U.`^"...Y. / � �•�_
Owner's representative: Total number of floors •.•••••
Phone: _ Z.SS- Pax; 3 f;-ma 5 1 `kW .•S CSL w dwelling arta(sq.ft,) ..........................
1,
Garage/carport area(sq.ft.).........................
Name: - C C Covered porch area(sq.ft.) ...... ............... . q1L—
Mailing address: r - + Deck area(sq. fl.) ............ ................. .......
--
,•1� City: State: ZIP: Other structure•arm(-y. Ir 1................. .. ....
1 ('hone: Fax: E-mail: CommerciallinduNriallmulti-familF: -
Valuationol'work....................................... k
Business name: - Existing bldg.an a(sq.ft.) ......... ....... ....... -
t — New bldg.area(,sq. fl.).................. ............
Adt r�ss:
......................
City: � State: ZIP:: Nurnblr of stories f''.... —
Type of construction............................. .....
i'honh I ux: E-mail: - —
Occupancy group(s): Existing:
New:
City/morn tic no Notice:All contractors and subcontractors are required to he
r licensed with the Oregon Construction Contractors Board under
Name: ! �1 / � provisions of ORS 70I and rnary be required to he licensed in the
Address; 1_ Z�'Z jurisdiction where work is Kling performed. Ville applicant is
City L Stale:CJ14ZIP: - exempt from licensing,the following reason applies:
Conlact person: Ph,n no.: -
� -
t
Name: &I �UJyN Cru:,,-A l'ontacl person: A UYl l t l_ Pees due upon application ........................... $
Address:-,_Z3jx �z--- Date received:
Cily � _ State_ 7.IP: Amount received .................................... b _
Phone: _l Fax :-mail Please refer to fee schedule.
hereby certify I nave real]and examin•:d this application;rod the SMA all Juduliclinru ween ctedll lards,I1le Aw call i1llt diction rot r•1111P inumina11rnl
attached checklist. All provisions o In-vs and ordinances governing this I U visa U Musterc•nrd
uork will he complied with, wIMIKS1x;•ilied herein or not. t rcdll cN11110110*1 [�_
Authorized si]nature: _�LDale:
li;pllPr
_ / Nana•nl cal dbnl.kl;u,brawn nn crcdll co _
Print name: K
- ` ----------- _— S _
--- — t'adbu111er dxnarurc Amcwm
Nntice:'This permit application expires il'a permit is not obtained within 1811 days ager it has been accepted as complete. W-4611 uMWOM)
a.
One- and Two-1 dunily Dwelling
Building Permit Application Checklist01Y qf Tigard It,acrcncc11l,
ard Assocratcd l •units:
City U Elem i-d J I'luminnr J Mechanical
Address: 13125 SW Hall Blvd. I ipard,OR 97223
Phone: (503) 639-4171 ---- -. - -� -
Fax: (503) 598 11)(10
1 M7MG ITEMS ARE REQILWED
I !.:11111 use 31cli4111%cungll,•Ied. 111•e lurn,hru, it 1,i; 1 i.i I 'I ,ell,III wIII ir,,,
rOil iit l l l,l,u i •, I,u lail,rrice pnuII., ,rI•.IIIIk il, l .I i A ii, a In,i ii, li.iii a i —
+ Verification of approved plat/lot.
4 1 it district approval required.
5 lieplic system permit orauthorization for remodel, Existing system capacity
0 .sewer permit.
7 Water district approval. - — _--
9 Soils report. Must carry original applicable stump and signature on rile or with application.
9 Erosion control U plan U permit required.Include drainage-way pmlection,silt fence d...,igu.and location of
catch-basin protea lion,etc.
10 3 Conlp!stn sets of legible plans.Must he drawn to scale,showing confurmancr to applicable local and stale
I
uilding codes. Lateral design details and connections nlurt he inco"irated info Alie plans or on a separate full-sirs
shed ---ached to the plans will cross references between plan location and det,nls. ITin review cannot he completed
if copyright violations exist._
I Site/plot plan drawn to scale.Thr plan mu,,l show lot and building setback dinensi�ms:property corner elevations(if - --
there h 1111Ire Ih,ul it 4-I1.elevation differential.plan must sh,w contour Imes al 2-11.intervals);local on of easements and
den, ,,n. I—1111 int of sinrcture(including dei ,),Ii,caunn of wellshepuc syslrn,s:utility locations:direction indicator;lot
area.bllddlllg coverage arca:1x•rcen1;IPV u1 L, •.11,,pe•ingx•rvious arca:existing structures on site-and surface dmmnage.
12 folmdation plan.Show,Innc11"wil,, anchor bolts•any hold-down and reinforcing pads,connection details,vent
ire and location.
13 Floor plans.Show all dimensions,room, identification,window si;e,location ol'smoke detectors,water heater,
)(mace.ventilation Fans,plun,binp IWIJI, balconies and decks 3)inchc.,above grade,etc.
I•i Cross section(s)and details.';im% all Ir,liuu,e-nlcmhcr sires and s,acing such as floor heams,lacmleas, i wf,,.sub floor,
gall constnactiun.roof consna non.Marc Ili;ul one cross section way be required to clearly rorty y c,m�u,Iruon tihuw
delmis of all wall and roof shenhinp,nlnlinp,rool slope,ceiling laeight,siding material,foulings and tomid,,l,un.~lairs,
fireplace conslnrclion, thermal m,iiLlikm.etc.
15 1?Iev8Uon VIMAN. III „ (it•ere,aunn 1,it new„m•.IrIli Urn. mininrrtn nl two A+ , u,„r Ii,r addilirn,s and remodel",
FAwriur elevations must n•lecl 111t•arlu it erad,• it Ilse,han}'r in !•1,ulr k err Ill n- un foot all building envelope.
_ Fiji] siie starei addendurlls showanp I,nrlldallnll vlr,;lu ar• gull iI A Ir n it plable.
16 Wall brach!{;(prescriptive pa(h)and/or lateral analysis plan,. %Iii i nrdreate da,ul .n,d locations:for
_ nun presuiptive path analysis provide specilicatiuns and calcul,u,nr•to engineermp 1 indards. _
17 Floor/roof frandng.Provide plans for all floors/roof assemblies,indicating member , ;tag,spacing,and hearing
locations.Show attic ventilation.
18 Basement and retaining walls. Provide cross sectia„Is and details showing placement of rehar. For engineered
systems,sec item 22,..Engineer's calculations.”
19 Beam calculations. 11r vide two sets of calculations using current code design values for all hams and multiple.ioists
over Ill feel long and/or any heanl/,ioisi carrying a nun-uniform Iniad. _
20 Manufactured floor/roof truss design details. - _ -
?I Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-prpmp schematic is required
Inc four or mole appliance;.
22 Engineer's calculations When required o1 lu „n1ed.I I.e . ,hear wall.roof tore"! hall he•.I;mlpcd by:In engineer or
arclulrcl hcrnuvl u,(hr1'nn 111111 sh,ll hr "!1111,n L.b, ;q,phc:,hlr r..il�,. ]rolr,I )(1111,r n•.• •u
7\,k
site plans are requited for Item I I above. Site plan. nnat he I,. 11 ur 11 .x 17".
s r•:,h arc required for Items 16, 19,20& 22 ahu\c.
lans shall not contain red liner or(ape-ons. — -- —— -
26 No rolled,reversed ur mirrored building plans will he accepted. - - --
27 -�
29
Checklist must he completed helore plan review s1:1r1 date Minor changes ,,r notes on submitted plans may he in blue or black ink.
Itcd inl is reserrlAed for department use only. UIJI,u 0011111 oxli
.et c:v J v . B: /;U' t1:01 AM; AG Vdr1 C:f10 nY!•t irtyrMyo L
FIuO :)1 02 07: Uf a P.
oe/on;tJI PION Ie: 1N PAX 60.: 5011 1tleU etT7 OF 1'1GA1tD Qc07
MechanicRI Permit'Appi ieation
City of Tigard -
14o}tgevapa.w.: Bay..e erre:
cltvo/1'yard Addimu: 13125 SW Well Bivd,'il jtud.OR 97'113 r"— ---
mcme' (503) 639-4171 Duerg.ual: �7' ftc^taptnv,:
Fu: (501)598.1960 cu.r,lcou Pttyniou►jnW
LA-duse lippiovol: _ - euudlrtspWrWIM,
L] 1 E :family dwel6uA ur arxiu my U cutnnt.1tr•.u:hn[fueutal U Mold-fe[ndy J I Etat tmpirnvommnl
JoNew axtauumon t AddltvWal
tt�eelttaYleylecrrtraeei Q t�lltk. _
l
lab rtddrt;u; ' � L�.�S.�.k� 1.:� ltt�t�e equlltment yuletitlea in Doae1 hetnN 1tkUc�ve tt;e tLo:••
L'!d .no. Suue ao value of aU ngech ks1 musnale,eyutp=L labor.ovenummi, 1
t 1'u mA taX ltwwtmnl no 71 j > pio�t.Vahee i ._ I
Lor �BlocJr sutx1vltM00: 1(t�t£5(►�i�i j % IP6ea chnoitJW for kmDortaot application(nlbrttetion ar::
r Pro�oot gamr: - tasltlhAloa'e fee actedole fbr Mldeetla!Pam foe.
v 7 cuyleounty' -I"" _. Tom:
L)e rW.um and _
fte(a) TOW
.-
l lfet daft of txmt leUatJw ecdott r^ _ ��. [ , 1 ltiaa soft Am,!*
Tloaul lmpmvt tntgttt or t wise at Kne: .y SYyup
unit
ON1
It c.11tQtnk rfr>,hr.�tra tN v�rtchppeed�U Tai ❑No -����urt tete rrau rT�'i �'
is c,cutinp gtwce Iuw n,'M7 OYea O � J
f H urfuv � r r1 tr.rI
"Bo�cala{rrerrKt .+
Hwittela name: Sta[e hotter pwtrut ov
HP Tau BTU41
�) ,wdm,t,M "�' 7 ._ duraactreecior,
I`n :- suee pk �zT'97t 0a Heat �e'viao �u,a'i
BTUIH
t f, Phtm.1716dL41 I AER:tri/_�i(��alL t' er_
1 — loohgele`dtra[worM/veut ut1e1 O Yee O No �
Tmpsiviip,..Inale"jobutin-suawdm.
l Gig hnnityllc.no well.wavorolousW
'1`Il�` Narue t atJ F �-N-FokAwavich6sim•ja ir�a_Kvi -
Abgorytion uNu..
Nlurtt chlueg
non
Ht' _
Addis► _ _.-- - -- -- t
1r1 : sltYs: zp
ap
Type ' to iicfianAsvrx S
Good f1n 10pprMIADr int=
Name: I 1(
Q YT- ( I (` E9ten,[t fire vWb t{aeb dna(bwb tang) S
•�I ) MdLu{a[kltpl:/ � t. 1 ' .�� - "'Tiewigg gmn, t rc�r, rr '.�
S y dtate 21t'l ( Pt
cit
T 11'Q NO Lilt
17tonet - - Fntt:S 1r• 1.L rve: I ar,ri nyrr 4 cudirn l
�.b) � � Nvreba d vutleu �—
Addreaeyi!'�__� '- f131�"�- �, _-_.- (?ecarsttytfl[eptntt ,',rj>—
7�rT LYz.Lj dv tR..._
Phone: Cisi, tD+O ■ ;waee- 1
Aj Appllant'1 ellrr:uum 1 �_..
Na[trc 1pflatlV :d.�� I _
fl
mt
Na Y VCM r�.wrt�t—at,pis--t.%iie ft N
.n.Mer rarw MInUmQ�!.........-....... �-
\ (]yin. :]itlante(Srd en a.11,:8 Permit a�pJeaCon Mftuam ee_........ S
......s
IOV.it"I t•r•.art u MA obleuted I'teo rrview(al — �) f
covet gird rn�.. _.,---- ---_._._ ..__ ���-r rpt utthin 110 cop af1w it has ham -'--
Stay. S
.rcrrtr.l s c.a,t•.w 1'rYTAL I.......,.S
14lectrical PermitAppiication
7Dm,
vw,00 0 C'lly Ol l l�ill'(� ct/appLn 1.' L�xpltcdalc:
Cil), IIK 1r,/ Address: 13125 SW Hall Blvd,Tigard,UR 9722.1ssued: _ 13y: Rcceiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file nci payment type:
Land Ilse appltwal.
'I YPU OF PERMIT
U I k 2 1:unrly dwelling or accessory U t mimercial/industrial _l . I lu family U'1•enaal improvement
XVew consuuction U Addition/alteration/replaccno+til J(Allcr. U Partial
��ilit role
Joh address: ) Bldg. no.: Suite nu.: •1•ax trap/lax lot/aCCOUnt l '
Lot: block: Subdivision:
Fagil
Project nnnlc: Description and location of work nn renriL. : �
P
Istinuned dale of cunytictinn/intipccli m---- --
1 t
!.tb no: _ _ 1 Ma%
13Ush,ess nu Jas 7 �" Description Oil. (ea.) I1,L11 un.imp
Addl'Css: � ^ New residnR4tl-+inai•nrmotel farnih Iw•tLON
-
i� _� doellhipunit.Includes atlaclwdpill agr.
Cit, I I �Q� Stilte: 7.11': —e - Semiceinc•ludtd: /
4j �l_��oA s 119)0 st n.or less ly
I'honc: s-!S I'nx: ►4- Is-mail: 1 a
Each additional 500 sq,ft.or portion thereof
CCD no.: /(fY� Glec.bus. tic.no: q_ Litiftedenergy,residential 14U 2
City/1 ro lie.numq&& -
_ Lhnitedenergy,noa residential 2
Each manufactured home or modular dweling
Signature(if supetvisingelectrician(reipim-l) date Service and/or feeder 2
Sul].elect.nnnlc(print) I ,,,,„ ,.,,,, -' Nervicesorfeeders-Installation.
■Ilerallrtn or relocation: ,
1 1 2110 amps or less r 2
Name(print): ► L1 t�l/C7iT 201 amps to,419)amps -- - 2
Millllllg address; r-#, 4(11 amps it 6(N)amps -_ 2
G01 amps to 1000 mnp_s_ 2
(5, y-: —- - Sial LIP Over 10001111p6lie volt% -- 2
1'hulu:: l'a------ :-111:111: 84eonnrcl only
Ocaner installation:'I'he installation is being made un piopeny I ownTempontyserrlctsorfeeders-
-- ---
which is not intended I` r SaIC,ICi rem,or exchange according Ira
Inlets llalloll,lilt crill loll,orrelocation.
ORS 447,455,479,670,711 :uu amps m less _ ( �(� 2
201 mops o,4(9)ramps i 2
Owner's sign lturl': Daw: 1 A�W� Alli 1a G110 nags 2
Branch circuits-new,alteration,
or eslensioo per panel:
Nan1c: 1 K -!_ t•' l _ A I ee far h.aneh citLuils wilh purchase of
Address. _ _ service nr feeder fee,each branch circuit 2
Clay: Slillc %I I': ` N. Fee for branch cireuils without purchase -- - --- --
' --- okerviceor It""IN fce.First hrmtchcircuit —2
I a,h:uldnn,nulb,awhutrmt
PLAN HENJ I'M(Plense check nil flint upply)
Mlsc.(Seri Ice or feeder not Included):
U Service over 22Sangs r„nuncrual 'J Ilr.dlh cmrlacililN k0llitunp01 tial awni.ncle 2
U Service over 320 amps-rating of Lt' U lin.ardous location Each sign or outhnc lighting 2
fnodlydwellirgs U Building over 10,O00 square feet fou or Signal circuit(s)or n liatiled energy panel,
U System over 600 volts nonlinul more residential Units in one structure alteration.or extension'
U Building over them stories U hinders,4W amps or more '1 k•scn mon,
U oLcupant load over 99lwisons U Alauufncuurd structures or RV park Iacit additional inspection over file allowable In anv of Ile above:
U Isgnss/IighlingIll all U rllhri - __- Per inspection ( - '-
S"bltlll—sefs of plates with arty of IIIc almve. Investigation fee
I he above Are not Applicable l0lemporary conslruclion service. Other -
Nor till tun,do nous accept credo cmdt,piens,,call poialicnon rot mole inftantaooa Notice: chis pernnit application Pl'I'11111 fee......................n t'Ito
U Visa U Mastercmd expires if it pennit is not obtained Plan lrvivw (:u .__ %) $
t•md1,cold nunds't —__-- / / wilhin Igo(Iays tiller it has been State surcharge(8%) ....$
-- _-__ accepted as complete. 1'U''A1, .......................$
mar of car f,n t r tic tiiawn nn i,,Li a.I ---V-
t
('tudholdet sigononr Alnaun
_ —� _,_- aruavls u,asvt un1)
AUCs-7-2001 07:09A FROM:EDWARD MULLEN PLUMI 503 628 4633 70:5035334306 P:1/1
nuy. b al &0711 FAY P.
2
1
Plumbing I'erinit Ap licatiun
Datareoeived: $ J l r r MMt
City of Tigard Sewer petnrll no.: Bul ldlnC pvr7ut rw.
Addrem: 13125 SW Ila 1 01vcl, I'ip,•1rd.01 L 97123
('NyofTlparw 1'ftvnr: (101)63911171 F*ro)al/eppl.m.: liaplredate:
Fox: (503) 598.1960 Date luued' By: Necelputn.:
I-and use approval' _-� -- - - Cuafileno,: I'synxxnrype: --
U I &2 fnntily dwcliing or accesatty U Cornmerc4e industrial q Muhl-family U Tenant irnprovernrnt
,WNew cotislrucUt r+ U Addition/all ratlorJrepiacemem U Poul aervicr U OCr.
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;;ITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
MULLEN PLUMBING
24470 SW RAINEIOW LAAE
HILLSBORO, OR 97123
Plumbing Signature Form
Permit #: MST2001-00447
' Date Issued: 8128/01
Parcel: 2S103BC-08200
Site Address: 12279 SW LANSDOWNE LN
Subdivision: MLP1999-00005 MOSES PP2000-077
Block: I_ot: 002
Jurisdiction: TIG
Zoning: R-4.5
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 compar.y sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbhig inspections will be authorized until this completed form is received
CWNER: PLUMBING CONTRACTOR:
WHITFORD SCOTT LLC MUI '-CN PL!IM..BING
4888 NW BETHANY BLVD K5 #381 24470 SW ;lAINBOW LANE
PORTLAND. OR 97279-9260 HILLSBORO, OR 97123
Phone #: 503-533-2255 Ph ine #: 503-628-1632
Reg #: 1 Ir. 92689
PI nn 34-260PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
1
FROM : ROSS ELECTRIC PHONE NO. 5036422800 Oct. 29 2001 06:36PM P2
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD. OR 97223
IMPORTANT PERMIT NOTICE
ROSS ELECTRIC
23810 SW DRAKE LN
HILLSBORO, OR 8712.3
hlectrical Signature Form
Pon-nit #: MST2001-00447
Date Iss:.ed; 43428/8 I
t arcel: 2S103�'C-08200
Site Address: 12279 h N LANSDOWNE LN
Subdivision: MLP1999.00005 MOSES PP2000-077
Block: Lot: 002
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Conhtruction of new single family detached residence. Path �
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electriral permit to be valid, the signature of the supervising Alertrician is required Please have the
appropriate individual from your aompfary sign below and reh-it this Electrical Signature Foran prior to the
start of the work to the address ,above.ATTN: 3uilding Dept.
No electrical inspections will be authorized until this completed form is received
U',NNER. F1 I-CTRICAL CON I RACTOP.
WHIT FORD SCOTT LLC ROSS ELECTRIC
4888 NW BETHANY BLVD K5 #381 23810 S',.4 DRAKE LN
PORTLAND, OR 97229-9260 HILLSBORO. OR 97123
Phow-fJ: 503-533-2255 Nhono#. 642-2800
Ilefa #: F-LE 34.4380
LIC *18821
SUP IN
AN INK SIGNATURE 19 REQUIRED ON THIS FORM
Signature of Supervising F;,jctriclan
It you have any questions, , 'ease call (503)639 4171, ext. # 310
CITY OFTIGARJ 24-Hour
BUILDING Inspection ; ine: (503) 639-4175
MST 7,_
INSPECTION DIVISION Business Line: (503) 639-1171
SUP
Received �._- Date Requested__ Z AM --- -_ PM BUP
Location -_�� - 1 suit - -_ .. _..---- MEC - - - -
Contact PerEorl -- _ Ph (- ) 4 9 G L 4: ( PLM _-- -_ -
Contractor - - Ph SWR -
BUILDING_ TenanUOwner Et
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain _
Slab I ispection Notes: - J SIT - -
Post& Beam
Shear Anchors — J --
Ext Sheath/Shear
Int Sheath/Shear 1-
Framing � �fX��1G�.• l 1� (V fel t ( I�ry��_,, _..---- _- -__
solation Qty I[ WA ---lid DrywallNailingNailing ---- - ---
Firewall
Fire Sprinkler ---- - ---- --
Fire Alarm
Susp'd Ceiling - ----
Root
Other --- -
S.SART FAIL
PLUMBING
Post " Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: _
Final
_PASS _PART FAIL
MECHANICAL
P6si 8 B''a
SM-ghTn — ------- - ------ -- -- -
Gas Line
Smoke Da,r,pers ----- - -----------___-�
ASS PART FAIL - - ----- ---------- -- ---- ---------
_ELECTRICAL
Service - --- �__--- --------- -- -._.—.--- -----
Rough-In - -- --- -----— --------- ----- -----
UG/Slab
Low Voltage --- -- ------- -_ _-._--__.�._-- - -�- -
Fire Alarm
Final
PASS PART FAIL �J Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
n Please call for reinspection RE: _ _- _. ❑ Unable to inspect-no access
Fire Supply Line
ADA _ � -_.__-- _
Approach/Sidewa"c Dat ___2 ._� ------ Inspector Ext_
Other:
Final DO NOT REMOVE this Inspvtlion record frow.. the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (5(j)639-4175 ,CO( 0 o q Y7
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BLIP _--
Received _.— Cate RequestedAM PM 9uP —
Location L Z- ��c-w� Suite—. MEC
Contact Person PLM
Contractor.--_-- _ Ph( 1 SWR
BUILDING �+ TenanUOwner ELC
Footing ELC
Foundation Access:
Fig Drain ELR
-- -
Crawl Drain
Slab Inspection Note: SIT
Post& Ream
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insul,tion
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS °ART Wt. - - --
P_LUMEIIN_G_
Post&fieam� —
Under Slab _-
Rourh-In
Wato oervice
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pat
e*_ ART_FAIL
Post R. Beam W
Rough-In ___--
Gas Line
Smoke Dampers -- - - -- -- -- ---- — —- -----
Final
PASS PART FAIL
ELECTRICAL—
Service ------- ----- -- - --- —___� —.__ --------
Rough-In
UG/Slab
Low Voltage _— --- --- .— — - ---
Fire Alam --- —�
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE [� Please call for reinspection RE: _.._ —__._._— — Unable to inspect-no access
Fire Supply Line
ADAze
Approach/Sidewalk Date / - Ext
Other:
Final DO NOT REMOVE this Inspection record from tho Jots site.
PASS vART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line- (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST --� -----
BLIP
Received Date Req ue ted '� _— AM .—PM BUP
Location �� L Z-- 0—(��`i1 / Suite MEC
Contact Person ._ Ph( ) �`{ �1 02-(e1 _ PLM --_ --
Contractor_— __-----___--- -- . Ph(—) _ SWR
BUILDING TenanUCwner -
Footing-- -- ELC -- ------ - -------
Foundation Access: ELC
Ftq Drain ELR
Crawl Drain
Slab Inspection SIT
Post& Beam
Shear Anchors - -----.--------- - . .--._—
Cxt Sheath/Shear
int eat Sear
Framing �N___�b1��-L'�Z ��— �Q Lllz)oEg=—
Insulation
Drywall Nailing
F,rewAll
Fire Sprinkler
Fire Ala m
Susp d Ceiling -- -- — --- - —__ __
Roar
Other:- —L� '�9_CAC Lt1�d-9UC-_-_I n.
_ SS PART FAIL ^-
-`— - - -- ---
P_LUM6ING _ _ --�-- - -- - - �- �-
Post Beam
Under
Slab .— Z�� ,�► �'!E �r _r--11��i—_ -
e
Waier Service
Service --- ---- - -- __ . --- — -
Sanitary Sewer 1 --
Rain Drains j�-`---_t�-__ ) �U(n_�(/ l —���J'ZS_ �� V
Catch Basin/Manhole
Storm Drain - ---- -- --- - _ ------
Shower Pan J
Other: _ _ - - ------— ---- -- -
Final
PASS PART FAP. --- -- ----- -- -- --- �_
MECHANICAL
Gas Line
Smoke Dampers
C>nal
ASS_ PART_ FAIL - - - - - - --
ELECTRICAh-
Service --- - .__—_--
Rough-In
UG/Slab
Low Voltage
Fire Alarm ----
Final Reinspe.-tion fee of$__---_ --_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE — F] Please call fur reinspection RF Unable to inspect-no access
Fite Supply Line I
ADA -- -
Approach/Sidewalk Dat• ( Inspector _- Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour vLL
BUILDING Inspection Line: (503) 639-4175 Ty
MST���y D C r
INSPECTION DIVISION Business Line: (50:1 639-4171
BUP
Received ___ _— Date Re uested___-__ Z_^`___ AM_— — PM _ BUP
Location __ 1 7 __— _Suited c,/ MEC
Contact Person Ph ( —) _�Z4' PLM
Contractor - _w �—-_ -- Ph(_-. ) _--- SWR
BUILDING_ Tenant/Owner _._ �._ __.-.--..__ ELC
Footing—
Foundation ELC
Ftg Drain Access: ELR --�-
Crawl Drain
Slab Inspection Notes: h� SIT
Post& Beam -- ------- C>2.,2 ------------_ ----__—___
Shear Anchors -------- — -
Ext Sheath/Shear
Int Sheath/Shear
Framing - -- — -- - - - -- ----------- —
Insulation
Drywall Nailing ---- -- - -- -- - - -- - --
Firewall ( �\ 1
Fire Sprinkler ------ '� q��stiS
Fire Alarm ------
Susp'a 3amng
Hoot
Other: ---------- -
Final
_PASS PART_ rAlL
-------------------------------- ------------------------
PLUMBING � -
Post& BPam _
Under Slab - -- --- ----
Hough-In
Water Service - - --------.._. _ - --- __... - -- ---- -- -----
Sanitary Sewer
Rain Drains --- - - --- _ -- - -------- ------- - --- - -- - --
Catch Basin/Manhole
Storm Drain - - - - --- -- - ----- --- - --- ---- -
Shower Pan
01h e i: ____ ..___-_.____ -
Final
PASS PART_FAIL —
MECHANICAL
AIL -------- - - - - - --- - -_- - ---- __ ._ --- --------—- --MECHANIC_A_L
I'ost& Beam
Hough-In -
Gas Line
Smoke Dampers -- - ----- - - -- -- - ---- - --- - - - - -- - - -
Final
PASS PART FAIL - - - - - - - -- - - -- - - _ - - - -
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
4%55r~) Ll Reinspection fee of$__--- __. required before nr,.(inspection. Pay at City 1Iall, 131,15 SW Hall Blvd.
PART FAIL
—--�.—
S Please call for reinspection RE:— -- -__ _ - _ Unable to inspect-no access
Fire Supply lineADA ! ,
Approach/Sidewalk Dat , / / �_ Inapect6r _ — - Fitt
Other:
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL
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