Permit CITY OF T SEWER CONNECTION
• 40,„yd, DEVELOPMENT SERVICES PERMIT
• 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 PERMIT #.. a ... > .: 4 / 97 0044
DATE ISSUED: 02/24/97.
•
PARCEL:.2S103RD —HG034
SITE -ADDRESS — '6: :'F2561iS.W' 115TH. .AVE _ -
SUBDEV.ISL'O'N. v... : HUNTER' S GLEN, • ZONING: R -4. 5 PD
BLOCK.......... y LOT ............. :034
TENANT NAME -.... :LEGEND HOMES
USA NO...........: FIXTURE UNITS. 0
CLASS OF WORK... :NEW DWELLING UNITS..: 1
TYPE OF USE—...:SF, . NO... OF BUILDINGS: 1
INSTALL TYPE.... :BUSWR IMPERV SURFACE: 0 sf
Remarks: Rath 1'
Owner - •. r. • FEES.
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST .• . • PRMT, s 220IZI 00: JMH 02/24/97 97- 290774
INSP $ 35.00 JMH 02/24/97 97- 290774
TIGARD OR 97223
Phone #: 620 -8080
Contract or: - -- -
CONTRACTOR- NOT ON FILE,.
Phone #: $ 2235.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS ---•
This Applicant agrees to comply with all the rules and, regulations Sewer Inspection
of the Unified Sewage Agency. The permit.:ekpires 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 -shal -1 °prospect 3 feet in all directions .:fro®: . _
the distance given. If not so located, installert.shall purchase... '.
a "Tap ,and Side 'Sewer" permit and the Agency - will 'ns•tall a lateral. •
Permittee Signature:
Issued By ;e I _..,11, �. �.1 ,F/f "L -
Call for inspection., — 639 -4175
,
Plan Check # OF-V2-le
:ITY.OF TIGARD Residential Building Permit Application Rec'dBy
31L5 SWHALL BLVD. New Construction Additions or Alterations Date Recd 00/35
'IGARD, OR 97223 Single Family Detached or Attached Date to P.E. Z f 4' -47
503) 639 -4171 Date to DST -/ - 7
Print or Type Permit# l, 't,9LII0 .' -
Incomplete or illegible applications will not be accepted Called
A�� c
Name of Subdivision Lot # Name
Job HUNTER'S GLEN 34 LEGEND HOMES
Architect Mailing Address
S ite dress
Address
1 25 65 SW 115th Avenue 6900 S W Haines St.
Name City /State Zip Phone
LEGEND HOMES Tigard, OR 97223 620 -8080
Owner Mailing Address Name
FROELICH
6900 SW Haines St.
City /State Z Phone En Mailing Address
Tigard, OR 97223 620 -8080 6969 SW Hampton St.
City /State Zip Phone
Name Tigard, OR 97223 624 -7005
General LEGEND HOMES Describe work new
addition 0 alteration 0 repair 0
Contractor Mailing Address to be done:
6900 S W Haines St. - Additional Description of Work:
City/State Zip Phone
Tigard, OR 9.7223 620 -8080
Oregon Const. Cont. Board Lic.# Exp. Date
Attach Copy of 060563 6/ 19 / 9 7 Project l C
Current COT Business Tax or Metro # Exp. Date Valuation $ /96 /J / 't 4
Licenses 1/97
Name 6 NEW CONSTRUCTION ONLY:
Name
Mechanical SUNGLOW INC. Sq.Ft. Hous.�• Sq.Ft. Garage:
Sub- Mailing Address ' 5-7
Contractor ; 2428 S E 105th Corner Lot . Yes No Flag Lot Yes No
-, City/State Zip Phone (check one) )( (check one)
Portland, OR 97216 253 -7789 Restricted ff`/'`¢ Audio /Stereo r i, Burglar
Oregon Const. Cant. Board Lic.# Exp. ate Energy - System Alarm
Attach Copy of ; 48131 '' 53v/%l
Installation p.A0 Garage Door HVAC
Current COT Business Tax or Metro # Exp. Date Pf
Licenses .1 q �
I 2-6 - �/
Name O / o/ ci Opener Systems
) (check all that Other:
Plumbing ; WOLCOTT PLUMBING app:y)
Sub i Address Will the electrical subcontractor wire for all ` Yes No
P O Box 2 0 0 7 restricted energy installations? X
Contractor Has the Subdivision Plat recorded? N/A Yes No
City/State Zip Phone A
Gresham, OR 97030 667 -9891
Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# Solar Compliance
Attach Copy of ? -3 0 4 7 10/19/97 (Calculation Attached)
Current Plumbing Lic. # Exo. Date I hereby acknowledge that I have read this application, that the
Licenses 2 6 - 2 0 8 P B 8/31/97 information given is correct, that I am the owner or authorized agent of
COT Business Tax or Metro # Exp. Date the owner, and that plans submitted are in compliance with Oregon
96-4281 12 / 9y State laws. .
Name Sig re of 0 er /Age Date G�
Electrical GARNER ELECTRIC �1) ' "`'' . 902// 7
Con t Perso a m e P hon
Sub- Mailing Address �- 20.
Contractor 21785 SW TV Highwa FOR OFFICE USE ONLY:
City/State Zip Phone Plat # Map/TL #:
Aloha, OR 97006 591 -1320 z /�
Oregon Const. Cont. Board Lic.# Ex o. ate 16�j 1 4 - 1 / y� 1 1R �J' . Z51 36' - H6o3
3.
Attach Copy of ,� 7/6 7.,L 9 / /4 /9 7 Se t f Zone: Solar:
Current Electrical Lic. # Exp. Date ��/
Licenses 34-305C /r , fq 7 li l\' R-ilci(i)
COT Business ss Tax o Metro # Ex . Engineering Approval: Planning Approval: TIP:
,stsVnstapp.doc 7O 7.j� bb� D Dat �� ( 211E e.v,..-+o ad Oh,.
2 -(4-17
. ti
Permit # Account Description Amount Amt. Pd. Bal. Ode
`nsfq ?oo I MST. Permit (BUILD) 550. 5— ' .5 . 5� .-
v�
Plumb. Permit (PLUMB) 225, 225. �p
Mech. Permit (MECH) ii/s. -/S,
ELC /ELR Permit (ELPRMT) 25o, w 25a e_e.--
State Tax 3
(TA 5,3 s� 53, � '
Bldg: 2 2 '5=7- ,/
Plumb: //, 2 -= -
Mech: 2, 2 - "
ELC /ELR: /Z. i f
Plan Check
V-
MST: (BUPPLN) ,357. �
M /U
Plumb: (PLMPLN) -
Mech: (MECPLN) //. Lam_ / 1 2
ctC pt-N- •Z.o_
CDC Review (LANDUS) </o, cpx.p -
Sw247. 044( Sewer Connection (SWUSA) �2p 0 �- Qu.
Sewer Inspection (SWINSP) ,.? Sr,
Parks Dev Charge (PKSDC) /050 a ' , /O51.
Residential TIF (TIF -R) , , / ' �JOIA.,ekleAr'i.i I/ ir
Mass Transit TIF (TIF -MT) / 7 \I0tA ,' I I,
Water Quality (WQUAL)
Water Quantity (WQUANT) /0 V' , . tw
Erosion Control Permit (ERPRMT) 6 ovi 6V,
Erosion Planck/USA (ERPLAN) 0 7- 0- � i.
Erosion Planck/COT (EROSN) 0 2-6 , - v . ,7-
Fire Life Safety (FLS)
TOTALS: C 0 �1' 1l I I IT5, ` i
is \dsts\mstapp.doc
Rev. 7/96
5/30/00 Activities for Case #: SWR97 -00044
1:55:08 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received 2/13/97 JD RECD BON 2/14/97
SWRA010 Plan check by 2/13/97 BON 2/14/97
SWRA705 Sewer Inspection 3/5/97 MS PASS MRS 3/6/97
SWRA080 (F) Issue permit 2/24/97 JMH PAID DST 2/24/97
• SWRA720 Case Finaled 3/6/97 MS PASS MRS 3/6/97
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