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Permit CITY TIGARD SITE WORK PERMIT o , DEVELOPMENT SERVICES PERMIT # : SIT2000 -00011 +L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 04/13/2000 SITE ADDRESS: 14176 SW 128TH PL PARCEL : 2S109AA -ER016 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING : R -7 BLOCK: LOT: 016 JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: Y VALUE: $5,000.00 EXCV VOLUME: 100 cy LANDSCAPING ?: FILL VOLUME: 200 cy SITE PREP ?: Y ENG FILL ?: Y STORM DRAINS ?: Y SOILS RPT REQD ?: IMPERV SURFACE: sf Remarks: Grading for SFD- Note Special Inspections Required - Owner: FEES MASTERPIECE CONSTRUCTION INC 15435 SW ASHLEY DRIVE Type By Date Amount Receipt TIGARD, OR 97223 PRMT KJP 04/13/2000 $77.75 0001413 PLCK KJP 04/13/2000 $50.54 0001413 5PCT KJP 04/13/2000 $6.22 0001413 Phone: 503 - 267 -6730 EROS KJP 04/13/2000 $80.00 0001413 Contractor: ERPU KJP 04/13/2000 $26.00 0001413 MASTERPIECE CONSTRUCTION INC ERPC KJP 04/13/2000 $26.00 0001413 15435 SW ASHLEY DR Total $266.51 TIGARD, OR 97224 Phone: 524 -4371 Reg #: LIC 00069010 Required Inspections Erosion Control Insp 844 -8444 Excavation Insp Fill Inspection Grading Insp Strm Drain Insp Misc. Inspection Engineered grading final reprt Final Inspection ORIGINAL 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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Permittee Signature: y Issued By: i( Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day i, 1-',A , • - CITY OF TIGARD -t .5` Site Permit Application Plan Check# 3 -231 13125 SW HALL BLVD. 6 D ID , 111 ' . Commercial, Residential Recd By Gr TIGARD, OR 97223 and Multi-Family Date Recd 3 - /3 - � y Date to P.E. (503) 6394171 x304 Date to DST 4 1 t lin 4 Permit #S /T. -060 // Print or Type Related SWR# Incomplete or illegible applications will not be accepted Called roject Name Utilities (Complete all that apply) Job LtT Its 6S(ON Address Address f Storm Sewer iL/ri L. S It/ !2S �Iq/ kA 30 Linear Ft. Na / Sanitary Sewer , J fit 4-S T Clef i a cc CO —c T. 1 w c / Linear Ft. Owner Mailing Address 1 Fresh Water �. / SL' �-s k I Q y d `t.- .23 Linear Ft. City , Zip Phone 5 / Catch Basins T g 7Z-IV 2 v7--t # General Nam ,,, Clean Outs i Contractor � ST € (L P( e ce C O w- .1 1‘ t r C # Prior to permit Mailing Address Describe work to be done: issuance, a c ' - / NewO Addition❑ AlterationD Repair copy of all / 5%1 3 4 U �- C_! 4 S L 1 t 1 ❑ licenses are City/State Zip Phone 1 e7- 0.3 0 Additional Description of Work: required if -t- ( p 1 /.. /24) ai "?.- 5•2y- - expired in COT State Const. Cont. Board Lic. # Exp. Date database j � I G o t 0 / _ L/ - o ( Name \ f p t R K .S T C w /9- k7r Valuation $ L j 0 0 (S t 1 c: ' a Lk) Architect Mailing Address Plans Required: See Matrix on back page 1 R 4 1 h g' ltl ] k l7 lit/ e The following, must accompany this application: City/Sta a Zip Phone Site plan with Vicinity Map Parking (including 134fl6-1t14eTv., ' o t a 51- 9 i `f Q Showing ADA compliance ADA) & Lighting Plan Name Grading Plan and details Landscaping Plan 7'1. FS D, r/nbRi Engineer Mailing Address I Erosion Control Plan and Retaining Structures �� 7 00 S L U e'en.. / Oi --C`S rgy, .- details including calculations City/State Zip Phone 5'j - 2P-p/5 Site Utility Plan and details Soils Report T I t � o/L l �! 5. ZLf Syt 7 ^C (showing pp to a (if required) roved system) Excavation Volume I hereby acknowledge that I have read this application, that the information given is correct, that I am the owner or authorized l 0 cu. yds. agent of the owner, and that plans submitted are in compliance with Oregon State laws. Grading Volume Signature of 0 ner /Agent Date (Soils report required for >5,000 cu. Yds,) / O (; 01 3 Z((- 0 0 cu. cu yds. w Fill Volume Contact Person Name Phone (Fill exceeding 12" in depth shall be compacted tc\, < . ^ w f — V R. 7 k �- 61 3 a To 90% of Maximum Density) 2,p 1 2�{.�(31 cu. yds. Retaining structure? (check one) 'ock FOR OFFICE USE ONLY ❑ CMU Notes: ❑Concrete ['Other Total new impervious area including all Land Use Case # Map/TL# buildings, sidewalks, and paving col 0 0 0 Sq. Ft. i :\dsts \forms\site- app.doc 3/17/00 CITY OF TIGARD BUILDING INSPECTION DIVISION 0 2441ourinspection Line: 639 -4175 Business Line: 639 -4171 141 UP _ Date Requested V7- 1 AM PM BLD Location l ? 7- \ Z � Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: SI �� " �6 1 Slab Post & Beam Ext Sheath /Shear Ina Sheath /Shear \� ``�V v�'S Framing �c.-1 Insulation v � Drywall Nailing S • Firewall ` Fire Sprinkler v l� °v . Fire Alarm Susp'd Ceiling Roof ` Misc: Final 'NA � -4_.�Q T \--2-Q �, r ., t 3C-7) K� el. ... �_ PASS PART FAIL � PLUMBING it /Lei cor \/ \ / r l 'P v-N Post r Slab Beam _U Under l Top Out 1 Water Service ' 5 ��. ` � Q Sanitary Sewer Rain P - R n Drains \r271+ ` � . \ , �A--,. Final 1 PASS PART FAIL S W ■ .\--►•N 1/4 e_S N c...k k....:&'v•-__S MECHANICAL. Post & Beam Uf ` Rough In ‘ ) R � S Gas Line Smoke Dampers Final • • PASS PART FAIL h� l . - e ' A � � �v.-- ELECTRICAL Service LA-- ,■/ a_ do e-- (.p -, Q a Rough In UG /Slab _ Low Voltage 1 Fire Alarm Final P ASS PART FAIL NIC127 Backfill /Grading Sanitary Sewer Storm Storm Drain !Y 1 /4 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ I Please call for reinspection RE: [ ] Unable to inspect - no access ADA C1 A roac /Side Ik / � Date IA-0 d \ Inspector Ext Final c f5 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 4 - / : ' AM PM BLD Location 1p 6L Z " Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing ..: ■t+ �'.�` ��,� . ,. f• f•,-4;2,; ,�,_ ...�t.. o Foundation ...t� ` ,�, .�c+ ►�yY � � r ' �' o :� '. �, -1 ':1;� FP S Ftg Drain ���E;�:'.`s'�? ,•, .�1 TL. '._ Crawl Drain Inspection Notes: SGN Slab C L/` �--. — • SIT f7/0 V ' Q Q 0 / Post & Beam Ext Sheath /Shear Int Sheath /Shear - , • 1 t Framing "IA --Q 4 A l/v Insulation J J Y ? 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 Rain Drains Final PASS PART FAIL MECHANICAL Post & 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 Approach /Sidewalk Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By I Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors EL R - Restricted Energy Permit Roof nailing I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line • Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab - 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection ‘-st,t—•c INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS • CITY OF TIGARD SITE WORK PERMIT i I DEVELOPMENT SERVICES PERMIT # : SIT2000-00011 "L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 4/13/00 SITE ADDRESS: 14176 SW 128TH PL PARCEL : 2S109AA-05000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING : R -7 BLOCK: LOT: 016 JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: Y VALUE: $5,000.00 EXCV VOLUME: 100 cy LANDSCAPING ?: FILL VOLUME: 200 cy SITE PREP ?: Y ENG FILL ?: Y STORM DRAINS ?: Y SOILS RPT REQD ?: IMPERV SURFACE: sf Remarks: Grading for SFD- Note Special Inspections Required - Owner: FEES MASTERPIECE CONSTRUCTION INC 15435 SW ASHLEY DRIVE Type By Date Amount Receipt TIGARD, OR 97223 PRMT KJP 4/13/00 $77.75 0001413 PLCK KJP 4/13/00 $50.54 0001413 Phone: 503-267-6730 5PCT KJP 4/13/00 $6.22 0001413 EROS KJP 4/13/00 $80.00 0001413 Contractor: ERPU KJP 4/13/00 $26.00 0001413 MASTERPIECE CONSTRUCTION INC ERPC KJP 4/13/00 $26.00 0001413 15435 SW ASHLEY DR Total $266.51 TIGARD, OR 97224 Phone: 524 -4371 Reg #: LIC 00069010 Required Inspections Erosion Control Insp 844 -8444 Excavation Insp Fill Inspection Grading lnsp Strm Drain lnsp Misc. Inspection Engineered grading final reprt Final Inspection M 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 Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Permittee Signature: Issued By: Call (503) 639 -4175 by 7:00 for i ( ► y 00 P.M. fo an inspection needed the next business day 8/22/00 Activities for Case #: SIT2000 -00011 12:52:07 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SITA005 Application received 3/13/00 GEO RECD No Hold GEO 4/10/00 SITA008 Permit Created 4/10/00 GEO DONE No Hold GEO 4/10/00 ii SITA010 Check for prcl. restrict. 4/10/00 GEO DONE No Hold GEO 4/10/00 SITA012 Plans Routed to Plans Examiner 4/10/99 GEO SENT No Hold GEO 4/10/00 ' SITA026 Plans approved by CPE 4/10/00 4/10/00 4/10/00 RDP DONE No Hold RDP 4/10/00 SITA030 Reviewed plans routed to DSTS 4/10/00 RDP DONE No Hold RDP 4/10/00 SITA700 Erosion Control Insp 844 -8444 No Hold RDP 4/10/00 SITA705 Excavation Insp NOTE No Hold RDP 4/10/00 Special Inspection SITA710 Fill Inspection NOTE No Hold RDP 4/10/00 Special Inspection SITA720 Grading Insp NOTE No Hold RDP 4/10/00 Special Inspection SITA740 Strm Drain Insp No Hold RDP 4/10/00 SITA770 Misc. Inspection NOTE No Hold RDP 4/10/00 Keystone Walls - Special Inspection SITA775 Engineered grading final reprt No Hold RDP 4/10/00 SITA799 Final Inspection No Hold RDP 4/10/00 SITA032 DST Post - Review Completed 4/13/00 BON DONE No Hold BON 4/13/00 SITA070 (F) Ready to issue 4/13/00 BON DONE No Hold BON 4/13/00 SITA092 (F) Issue permit 4/13/00 KJP DONE No Hold KJP 4/13/00 SITA093 (F) Reprint Permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00 Page 1 of 1