Permit I ,.
CITY OF TIGARD • MASTER PERMIT
PERMIT #: MST2004 -00402
Ill?' DEVELOPMENT SERVICES DATE ISSUED: 5/25/2005
"" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CD -11700
SITE ADDRESS: 07683 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 015 JURISDICTION: TIG
Project Description: New SFA.
BUILDING
REISSUE: WITTENBERG STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 891 sf BASEMENT: sf LEFT: 4 SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 1,126 sf GARAGE: 395 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT:
VALUE: 198,940.70
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,017 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
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: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL:
1000+ amp /volt :
PLAN REVIEWSECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: ALL -ENCOM BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
LEGEND HOMES LEGEND HOMES CORP and all other applicable laws. All work will be done in
12755 SW 69TH AVE # 100 12755 SW 69TH AVE #100 accordance with approved plans. This permit will expire
PORTLAND, OR 97223 TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 Phone: 620 8080 adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
Reg #: LIC 60563 direct questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 6,745.79 1 -800- 332 -2344.
REQUIRED ITEMS AND REPORTS
Issued By : g (e -U Permittee Signature : d �i9, ....'a rtz- /! .
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
■
Building Permit Application �`fi: , .7.ri t /, FORyOFFICE USE ONLY F3 `,�
City of Tigard C IVE Date/By: � ! Permit No. � l)'/
2 Plan Revie ° w ems+' Q
13125 SW Hall Blvd., Tigard, OR 9
Phone: 503.639.4171 Fax: 503.598.1960 p Date /B t1(1A �- % - , - OtherPennit `� nt Q ' A /
Inspection Line: 503.639.4175
Internet: ° F� Date Read /B Juris: 63 See Attached Checklist for
p DEC 2 0 2004 "`- : Noti
._�.. Ready /By:
,2 _ (r
rnet: www.ci.tigard.or,us fied/Metho Supplemental Information
CITY OF r S
,,,:•�•,..�., ,.... �" •:,�,..M_...._.E�......•,, .� CHAR �:. : �- - >�.�,...,,
gick( f � •.`fie "�` ...1F" \, '
RE "' L7IRED DAtGA:x'1 .A1V" `Z'- At�L1i Y 11lVE1 L
�� � :,•: ° .
Eg New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration /replacement ['Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
W eir, .�'.� KCA `P.EGO.RYOF�CONSTRI7C'i`t0��'. �*�w�s° �.<�<:
Valuation: $195,230.10
® 1- and 2- family dwelling ❑ Commercial /industrial
1=1 Accessory building ❑ Multi - family Number of bedrooms: 3
111 Master builder 111 Other:
Number of bathrooms: 3
"''"` % Total number of floors: 2
lifer :q o
.''�:•, - JOBtI'TE,:?INF..ORM °AI%'IUN �ND �Q"C�?cTI01� >' � ;`� fi
Job site address: 7683 SW Alder Street New dwelling area: 2009 square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: 395 square feet
Suite/bldg. /apt. no.: Project name: Hambach Grove Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
� U.IREBj`DAT' , `GUIVINIEIZCTt� � :\ GH)J � ° °"
Subdivision: Hambach Grove Lot no.: 015 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
`}m"�;.,: A.'g,L;� _: ' "v 1' %� (,':4 ':�R e:C�'. off: :',R2 ,:,3 :• .� • „a, :l•'y : ":'�,° �.e din }
.: >• _ °: >K ` ` r ”: =:... ;;;:,,: >.,,,x work indicated on this a
��: •D�S,Cl2CP`L�iOt�t �',0;�'� V \'YORK ° :�: .:�;' PP lication.
`�;'`:�:.�. ,,, .,,,, .� %�n�".a :`:'.�� " M'•"£ v�sr "��`Fac9'.:��; "t ,.n.� �i�2;�i.: ,.'.. ., ....a,nr„ oy. % ,':'•9a .. ,,,
Valuation: $
Existing building area: square feet
New building area: square feet
M { a =` iE 1NT Number •.❑ 120PERT �'O�VI`ER ` °`' '�, N of stories:
Name: Legend Homes Type of construction:
Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups:
City /State /ZIP: Portland, OR 97223 Existing:
Phone: (503)620 -8080 Fax: (503)598 -8900 New:
P' CONT -W .RSON , s`
A J' iCANT � o '� �
a
Business name: Legend Homes All contractors and subcontractors are required to be
Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -8080 Fax: : (503) 598 -8900
E - mail: slucas @legendhomes.com
g.; Sr X :.�;„ rv ..z�• � -sr „�. sue' �..��
' arGO1YTRr1GTQR o.,„;;, ..v."",
Business name: Legend Homes :< �`' ` °: g i x✓ IT ES fi ;?✓-
V- ..: j r PER I 2° FE „„ C4
Address: 12755 SW 69 Avenue, Suite #100 �� �����
Please refer to fee schedule.
City /State /ZIP: Portland, OR 97223
Fees due upon application
Phone: (503) 620 -8080 Fax: (503) 598 -8900
Amount received
CCB lie.: 060563
Date received:
Authorized signature: permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Steve Lucas Date: 12/16/04 * Fee methodology set by Tri- County Building Industry
Service Board.
Building \Permits \BUP- PetmitApp doc 12/03 440- 4613T(11/02/COM /WEB)
01/16/2003 00:15 6427925 PAGE 01
'DEC -D1 -2004 WED 04:30 PH Legend Homes FA}( NO 5035998900 P 02
Electrical Permit Auolaeatle ' a ti � `,.1 h< t lllt t tl I ff�ll In t Ir t ..:..4 ° t 1
te r ms pgIITte140.7 s.
C of Tigard E C E I ''l �
13123 SW Hail Blyd « '1lgard,CR 97223 1 ' , PlenRev Ottvr Rntsliu
In Phone: 503,6394171 Fax: 503,501 : "a i ■ , :r ,
epeetton Line: 003.630.,1173 I ti. J 1 . • ' to.tadyi8yi Pep s tor Z ® Nonn e dlbtedmit — sappienuaat lnrer.uden
internee www,ai,ii$ard,01'.Ui DEC a w r r t ry e
�' ,11- 1 I . it ' Fi �� „ it a, . 1 �
' iI� 'ff11:'Ii r4 Yic(i1tr� 1601 i�•' , tt I c 4 1imil i ° (1. S i I} J 11 1'7 I,
i
PI i
a1� it�?VH+1�I�l'nr'f;, � �Eil � l �s ..t,,l. , r , _• �, II g ', �j - 1.1 i -, .:, ,, ,!. Ettat JlL i. L
��T� ,2 I ��pq 1y� . 5 " 1 ` �d Maw gheokstl' tlppiY
►�+ �'WCp►tlllyµetlon A , rtLT7T �715 09ervice OHessrdouelocation.
a Of 99 Other N ;: ^ !1, 1 ,,,,,-,N •i ('Service aver 320 amps - rating 12 Dentin eve( 10,000 di. f.,
z 1;1'` { tli �{r'.!l;� �; ifs �I RIFt) ' i i, Iri'et , 1a i'' y ni 4 :) � t : ' 41 1' ,. of l- et d 2 - t.mily dwellings 4 or c➢lore nav raldantiel
b uildin Q tam over 600 void nominal snits in one mom
m
i- atld familydtvelling 511 CelnntrrelaUltattssalsl iIl• Accessory 8 Cladding Dyer dnsatmrla QPeedem 400ampenrMen
O Mu1tt•thn111 ■ Mader builder ■ Other r v�}1?? � Claccupaatload over 90persons Q perk
maatun or
11$21:011,15W011, t 1 e trlq glI I, I tine 1� tl tl . J t i T i `I .. } h 'r ' ' � • .� h ,`',1'.15ti' tit yy omrlisottng plate
:
P{� F Ih,:,�'!,:':,,'.I .1.�1�a n. n 1 ... Ili i�
,, �t 0 Oilier•
❑Fiael►h-¢ ere facility
Job no.: Job site address: " ( ,! Su tcL17'Ep- ' - submit,, sett or plans with WY t ttte above.
City/State/ZIP: Tigard, OR 01224 The abov' ore not appliessieto umpianey co'ti' 0h service.
C F yr S � Y'��.�.f 7 I ,n tlP' I.1 � t j ,
9vise/b1dg r ao.: Ptojoa motet Bombed Geovc 'L a ell t,,1� 1;.1' :1L ... _ �' _ v ii iAR
O.
111
Crol2ltredt/dltectlone job eel 1Ycwroelde .dst due* or mwU.ymilydwc1hi MIL
Isstol attoche4 5er■ga
1,000 ud sv, 0 m Teri t 145,15 145,15 4
Lac no.; O IS no. add9 300 wilt. ar sedan 3 3 3. 40 tow . Z° 1
Subdivision: Hambaeh GluovaG Limited energy, residential 75,00 Q
Tart y eel no • Limbed energy, non- realdential 75.00 2
a SIC ,il l(ifjlilir,llilt iiilit i : l;;,.,a ,i l i l "t D Cf!' M! "i I L !li SIR I liffi- Esoh nun:fun:red ortegulsr
..
d wee vrapoor. L old:or ender I 00 ., _ . . 2
Services or feeders Insta rater% nitareike, a flier relocation
200 snips or leas 1 - 5030 IIIII®
yam; �+,1' 111ir1 A!5 t ' J u 1 1 ' pI 0 1 1nr1i� 111' lil I Ilrl � I>{f n ;i t ttiit ° y� t Fl � ^`t',ti''1 201 �'et0400 � .• lf)1'f.1lS
i4r 'i alt �t`JIv viii 1,;;, 4 r• .'{it'1..:, ' Y!!, ,SI , (Vl �I' !ti l . ,,,,, h 1� �iE'L. ,t,� � .w,.,w.L l ..�. i..ui! is 401 am , to 600 nova 160.60 IIII
Nemo: Legend Romeo 601 amps x01.000 erns 240.60
-'---- •
Addr59s: 13785 SW 69' Avenue, Suite #101) Ova 1.000 arse er yells 434 63
Reconnect ml • 66..83 11111 i
City/State/ZIPI Pordand, OR 97213 Temporary mervieea or feeders Iartiliatlen, alteration. and/or
rewrotte°
Filson*: (903)620 - 11080 I Fes (503)59841900 Zip amps or teas 6623 1
Owtser itt5tailaltton: This in*i .It ti0e Is being mode on property that 1 own which Is Mt 201 amps w 400 oln • . 100,30 2
initnded for 3015,10555, twit, or exchange, aeoordl rag to ORS x47.449, 670, and 70 401 a .1 al 600 smog 111.11E15= la
Owner signature Date; yeah events- mem'teratisti, or edam' Prod
v ,, a. hP ° i t" �� v Tt 1It. ,, r �' ,i t' , 11r A pes forbrarroh elraufu 4411
1 ia { �jl� Y h!Ni_� .. I Y rAlo 1, {.!=.. FI g4p,il9�LI BS+'ln�:d_: „;�I, . '
i,. tn,♦ �l. F,.1.4., iG'v1e00tl�edKhe,a�Cit
ArMen Orval 6 G3 2
a Fee 1br brwteh eireuhs
Contoot name. Steve Lao*. wtrhaot eery a fender 13e. 48.83 2
lac •ranohcircuit
Address: 12199 SW 69i Avenue, Smite PIN Soh add'I branch chalet CO 2
City /Stote4 17: POKOInd. 97223 Mhcene tat (rsrrit,or rater let Included)
Pump or :Holden circle all 53.40 =d
Phony (903) 6104090 . Fax: i (503) 398.8900 Sign or outline Ii in < 11.1 53.40 Ell
E -main slucosQillcl.edhomee.com a arrange)
fl gryt���}i1A a I� N Its ����p I, SIBn ,ails) or limited
t � i � fj It;t I� Ii�;}f��1'��{�j� °t t ( I °l 1111,:,. �i�1 H; Y:ti ��i� iltilii21 1 I r i 1 9 51 ¢i rt'YJiIINI'k+iM 'iila :l1 •n ^ 1 R • atte7atian, or • • ?ago . a : .
1!1� 1 f:.uEJfllC[i� t��l>>N. tieaf fl I�..11' t .� c ' ',.' IN I' I;;.IiRi v!' :� extedslen. pa oribe:
Business tie m>et Garner Bleeeirle
Esob additional l.ipeettua over allowable In a of the entire
Address, 2920 SW 247 Avenue 9 A par inrueetien r 6250 IMElini
City/Maw/Zlpt fIUeber e, OR 97123 lnveiri . , • an , er hour ,Movie 111.1111111M1.11011111111111
�-
Phone: (303) 591.1320 gpx: (, • 642-792 industrial lent .or hour
kRiligA t Inarilabo'kiiffti2EaCiLin
CCP Lie 121199 Eleetvleal Lie, id I S •rv, Lie.. 37074
Suprv. Electrician signature, 'Antral: / • / Plan review (2176 of permit tea)
Slate mocha's* (174 at permit had 19 .(03
' ` • ” ro AL VEWISIT FEE 2.4.4- AS
Authorized signature; iris prat vital:efts soiree tt a permit 1 eeataal x►th» MO
dsya ansrlt hat Deooescoptod eteeep4xe
Date: • Fsa lnedlodolOm Ilatby Tri-COwny i1WI01ne u>ausDy 9+rvics Dania
as minim at impenaav per penult It allo ed,
illubous1rsooliell4tedsOsples dos 440.4415Tpew►ycciwu'sa
Mechanical Permit Application ��
; 1-' 1.10,P OFFICE US,E ONLY 41;— 44 "t
y Tigard RECEIVED Received Permit No.:
Cit of Ti and Date /By:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DE G 2 0 2 00 4 Date/By:
Permit:
j
l y
Inspection Line: 503.639.4175 Date Ready /By: Juris: RI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
- :r' HECK T
�; 6 .�� � ; �:_ `;�� ' JViER •,T``':
® New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
rt,\ar n;.d � ;,« ":..t. , kli ;r.; n>.=�:,• r`raraac .a;. '��. .i''rf@,.•„�,.c,i.-. , Value: $
_ . , CA t' E*, t , CO SIT 10\ fa 3
ESIPPTI L E(111rP.14i1+1Tw°ig,§ C S
ISEES "";,�
►/ 1- and 2-family dwelling Commercial/industrial Accessory building " "' " "` " " "'-`' " "' "'`'' "'` " ° "` " "�
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
�: ' >.' - .:J TF 1! tai "1�r':'.AN ,, ._ _.....r ? 1, ' �
:> . >.. , ,,,. ......�. a B S N�()� Q 1. D 1rOCA ifJ1V: �
77
:w�.•,�o- =A ^r %. •?d•,,., � Heating/cooling
Air conditioning or heat pump
Job site address: 7683 SW Alder Street
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: Hambach Grove Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Hambach Grove Lot no.: 015 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
„, , .. .•.. > ,•.:• .. Chimney/liner/flue/vent
r l KPE a El NE
C}WR E NA"N.T.
... `.`�� �� O .," .<� Other: 10.00
Name: Legend Homes Environmental exhaust and ventilation
Address: 12755 SW 69` Avenue Range hood /other kitchen
equipment 10.00
City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)620 - 8080 Fax: (503)598 - 8900 toilet compartments, utility rooms) 6.80
,., ....; .. s. , X.:. ;;.` „• 1 00
,.t ` "" v. ” "�`� = � `• °� Attic /crawlspace fans
® A °�P.G1C'ANTre�•, �� ?� _��C?NT�"ST�P,<�itSONr�
.��,,.�, ` -�c: ?. <� ��?r. .�> .,,.;•.> �.•e.... .,_„w,xWiser,_...._.,. amt: W..- ,.,.,.,r,•�,.h,,-= :.....:.... ...�� �,:;..,: > :< �''
Other: 10.00
Business name: Legend Homes
Fuel piping
Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional
Address: 12755 SW 69 Avenue, Suite #100 Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97223 Wall /suspended /unit heater
Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Water heater
Fireplace
E - mail: slucas@legendhomes.com legendhomes.com Range
IMF r43s.;N., . < .. •:;; < r;;- >r>:we Bar
;' CO N K °' CTO.K _ 1., ; ...;,.,.. Barbecue
Business name: Tri County Temp Control
Clothes dryer (gas)
Other:
Address: 13150 Clackamas River Drive �: k >` >- °N >FM H j� I " : I '' : = 'S
�.... � �_�. = AERMI`r'EFSFa
City /State /ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 557 - 2220 Fax: (503) 557 - 0919 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 72623 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180 g ? ;; X days after it has been accepted as complete.
Print name: Steve Lucas Date: 12/16/02 * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (1 I /02/COM /WEB)
Mechanical Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Commercial Fee Schedule:
F °ip : ', > of .er mit`Fee �:: .:F_`' te e.;_
otal�?�aluath, ���, y� :.,�:.W�s ..... �.��.� ...
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
is \Building \Permits \MEC- PermitApp.doc 12/03 2
• h,
Plumbing Permit AAKEIVED .
$:\:`,V,,,..,;' d' z 4 �, t i'-'!1,,,I4-:,'X : I St a Sy �t ` a�X . f y e ar
� x ' F OR UEFICE SEOIV LY g '`
£ f
..: fix . .Y?. v+, �' - i s ew..� x -s �. � � p{«` ° �� ,.Z?.,. n'2,'_ , .e.
City of Tigard
Received
Per miit No
e
13125 SW Hall Blvd., Tigard, OR 97223 DEC 2 V 2004 Date/By:
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 '" - , 1, Date/13y: Other Permit No.:
24- Hour Inspection Line: 503.639.4175aITY OF TIGAR 1t. y,. 1I„ . -. Date Ready/By: Juris: D 'See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISi • - Not fied Supplemental
-... .. 3?' S 4 �S .. .. . . w , " ., . : : "� �eak . &.ca ,". ,'F� 4�`3]"F.s'N+•. Notified/Method: +� -: 5�+
w Doe Su nlall
nformation
4;:, Wit,. " :.,' 'w; i
� '' a,.� Ti � :;,: a <,r�: �'�'� -�. �,�. � �w� z >. � �' ��`,� �:.�.
-,�_- w :,.. � <�n:?t<�: " ".2 „. " .-,t:' +., s+�:.�,.<�•c - .- :�ax �"��.« ..�r r „�=-=" :�',�-:.i� i�``+w= ` .�' - ` -max w,�M.�., r R.° „ -via .. ,
SI New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
� ,� �_��w.� � �- s � ,.... - ���. <;�sa �'
< '� t , , ,,, ; Q Q S GRUCTI ��.. �`-.:.. z SFR (1) bath 249.20
I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
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Job site address: 7683 SW Alder Street Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Hambach Grove Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Hambach Grove . I Lot no.: 015 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.
s dY no.:
_ Absorption valve 16.60
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Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
°a t; < >_ Rs:, Drinking fountain 16.60
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Name: Legend Homes Expansion tank 16.60
Address: 12755 SW 69 Avenue, Suite #100 Fixture /sewer cap 16.60
City /State /ZIP: Portland, OR 97223 Floor drain /floor sink/hub 16.60
Phone: (503)620 -8080 Fax: (503)598 -8900 Garbage disposal 16.60
4 a _•.,,., � *,.�t , .�.� �:� , :�.�; � . «.,s�- >,- <'x � ��"° r °::,�t, >, <,,: - a -:yn� Hose bib 16.60
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Business name: Legend Homes Interceptor /grease trap 16.60
Contact name: Steve Lucas Medical gas (value: $ ) Page 2
Address: 12755 SW 69 Avenue, Suite #100 Primer 16.60
City /State /ZIP: Portland, OR 97223 Roof drain (commercial) 16.60
Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: slucas @legendhomes.com Urinal 16.60
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`:;" CO TRACE °OR = �: < 16.60
'�;?� tY;'`:_ ,E: � , � . ; �,.Y Water closet
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Business name: Wolcott Plumbing Contractors Water heater 16.60
Address: 1075 W. Historic Columbia River Other:
City /State /ZIP: Troutdale, OR 97060 Subtotal
Minimum permit fee: $72.50
Phone: (503) 667 -1781 Fax: (503) 667 -9891 Residential backflow minimum permit fee: $36.25
CCB Lie.: 23847 Plumbing Lic. no.: 26 -208PB Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
TOTAL PERMIT FEE
Print name: Steve Lucas Date: 12/16/04 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i \Building \Permits \PLM- PermitApp doc 12/03 440- 4616T( I 0/02/COM/WEB)
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CITY OF TIG64RD
BUILDING DIVISION ., •
#: MST2004 -00402
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2005
Phone: (503) 639 - 4171 "A pnlii r
Inspection Requests (24 Hrs.): (503) 639 -4175 �_ &- .
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 11
SITE ADDRESS: 07683 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 015 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: New SFA.
OWNER: LEGEND HOMES, PHONE #: 503- 620-8080
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 018404 -02 503 - 849 -5247 N
Corrections /Comments/ Instructions:
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X PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FQR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ja Date In J � U / � p Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004- 00402
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5125/2005
Phone: (503) 639 -4171 /omirill�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7 :02AM PAGE: 12
SITE ADDRESS: 07683 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 015 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: New SFA.
OWNER: LEGEND HOMES, PHONE #: 503-620-8080
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 018404 -01 503. 849"5247 Y
Corrections/Comments/Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL I f CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: tot( ti 4 Phone #: (503) 718 -
CITY OF TIGARD ' .
BUILDING DIVISION PERMIT #: MST2004 -0040
1.3125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2512005 •
Phone: (503) 639 -4171 d lm�� i � � l l
Inspection Requests (24 Hrs.): (503) 639 -4175 _.:� `__..
INSPECTION WORKSHEET FOR DATE: 10111/2005 TIME: 7:08AM PAGE: 9
SITE ADDRESS: 07683 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 015 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: New SFA.
OWNER: LEGEND HOMES, PHONE #: 503-620 -8080 1
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 10/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Plumbing final 017982 -01 503 -849 -5247 N
Corrections /Comments /Instructions:
Ad " 44" ..d... -Awr ' / - - V
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ASS RTIAL APPROVAL ❑ -CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ` Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MST2004-00402
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2005
Phone: (503) 639 -4171 �yV ml��ll�
Inspection Requests (24 Hrs.): (503) 639 -4175 J !:�
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 27
•
SITE ADDRESS: 07683 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 015 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: New SFA.
OWNER: LEGEND HOMES, PHONE #: 503••620 -8080
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 10 /10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017861 -02 503- 849 -5247 N
Corrections /Comments/ Instructions:
V I PASS RTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspecto Date: /0 Phone #: (503) 718-
%