Permit • CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00281
�.1i11 DEVELOPMENT SERVICES DATE ISSUED: 10/13/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07975 SW LEISER LN PARCEL: 2S112BD -LP013
SUBDIVISION: LEISER PARK ZONING: R - 4.5
BLOCK: LOT: 013 JURISDICTION: TIG
REMARKS: New SF
BUILDING
REISSUE: LP013 -A1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,217 sf BASEMENT: . sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,338 sf GARAGE: 537 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 253,314.30
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,555 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 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: BOIUCMP < 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 *•
rl
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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
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: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,009.66
This permit is subject to the regulations contained in the
LEGEND HOMES LEGEND HOMES CORP
Tigard other Code, State of l w kwil Specialty done 12755 SW 69TH AVE #100 12755 SW 69TH AVE #100 and all other applicable laws. Allworkwill be done in
PORTLAND, OR 97223 TIGARD, OR 97223
accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 598 - 8900 Phone: 620 - 8080 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 60563 rules are set 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
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
P st/Beam Structur I Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp
Is edB y (�-
1�I -�""
L �/ �i.A1 Pe rmittee Signature' �. i.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
•
wilding Permit Applic i EC EIV E r �� I F FORIOFFICEiUSLONLYF x .k;; ,�
C t 14 .., mr •. - a, p +.n,'P N' -. e ,^ .r4„ ,, ,e -,.. .'' k . 6::±.. �4 a , .1 rs . . ; '
City of Tigard Received : —/ . /' e f AQ Permit No.. 6'Q y ' -taZ
13125 SW Hall Blvd., Tigard, OR 97223 , Plan Re vi ew
Phone: 503.639.4171 Fax: 503.598.1960 ��°'0/�i� "I .. Date /By: ti) p Oth Permit: 7
P 21 10 /v - - /a �( ay d0 9
Inspection Line: 503.639.4175 OF TI • " I I I - Date Read /B / luris H See Attached Checklist for
p CITY Notified Method: IO/ / per t7 ` n � Supplemental Information
Internet: www.ci.tigard.or.us BUILDING DIVISION + - - _
V -
` TYPE OF WORIC REQ IRE i D = 1 A1V FAMILYDWELLING.'
® 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
41K work indicated on this application.
_ 3 - C O 4 CO NS T RU CTI O ,, f . .F
Valuation: $249,131.10
® I- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 3
° � D LO :, Total number of floors: 2
JOB S ANCATION
Job site address: 7975 SW Leiser Lane • New dwelling area: 2555 square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 622 square feet
Suite/bldg. /apt. no.: Project name: Leiser Park Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA COMMRCIAL -CSE C
Subdivision: Leiser Park Lot no.: 013 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
'r �_ DESCRIPTION O WORK r w ork • indicated on this application.
,410-g, � . � :.. tea, . ,,.., �. � . �;: 5,, 2
Valuation: $
. Existing building area: square feet
' New building area: square feet
❑ ERQ L O NER 4 0TEN t Number 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:
u ®1APPLICANT C PER SON::i it - ' ; ;-
-
_ . ..r '. - . ; '� r.: __ -mob . NOTICE ,,C
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
applicant is exempt from licensing, the following reasons
City/State /ZIP: Portland, OR 97223
apply:
Phone: (503) 620 -8080 Fax: : (503) 598 -8900
E -mail: slucas @legendhomes.com
1 't" ' R. CON A CTOR sf ' a�: r fff
Business name: Legend Homes � , _,. `BL71LD1NG PERMIT FEES* _`. 4 ,
Address: 12755 SW 69 Avenue, Suite #100 � r `
�����
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 - 1io.: 060563
Date received:
Authorized signature: i.. This permit application expires if permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Steve Lucas Date: 9/20/04 * Fee methodology set by Tri- County Building Industry
Service Board.
i. \Bwldmg \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11/02/COM /WEB)
11/04/2002 05:34 6427925
.:6 •-•!:".;;;,-; ": •;,--.., ,. -.-;,>,-.::;., - ., • • • • ::••-: •-•,...., -- - -• , .: . --• PAGE 04
J l ' SEP-20-2004 NON 1110 AN Legend Hornell .. — FAX NO, 5035988900 P. 05
...:
E ell Permit . VED A• •
..,,,4 „.,., ),, ,...,. :-.1. tir.i. i•
City of Tigard laSinilli.111111. 1....' us 140.: \ - c_2,00 V GO , 1)
. 13125 SW Hall Illvd., Tigard, OR 97123 r n 2
1 20011 FEii1111.11.1111. oth.P.6. •
Phone: 933.630,4i7i Pax soa.sougar
Immeation I.Anot
503.63.4175 ..- :I • Oemiusetellyi oe - F.• spool:011hr
want wynv.eiaigarder me CITY OF TIGARD Nottnesirsseinoil: 9 , •,• • •• - no larerawsioe
• • - ' ' • ', , • i ' 1; --: .trt•ii. , )iirii• a:CLIrl ..! ...,., ■ li', i' ', :. ';!iii,
11..1 00 'I.+ 04 ili 1011.15M12:4-19111A 1!!!ft;11,1, l'id, it i CUM 1.110.'1/i ;Iii i 1 0 1' t ii , i
. t. 43.7 ‘ i i4.1.;: .-.1i.. : ... .. 1, _. .:-..
El New construction • Addition/alters% on/replacement P chock oli that apply:
LIOService VW 225 amps, stamM'l 1:11fasartlaus laeactan
• Demolitio41 0 Wier, 0 SOO* over 320 amps -netts pauiltIns over 1 0,00 all • £I
. 'h1 , 111 iii:Ill!1';•;:::1'''''''1'14,-:!7:1?l'014747007./.0..!•; 'J171.4...1111;V' I ' l ''; li . :';l'I 'll .'ll i !' a I - and 24aral clwal Unita 4 or nrre 1 " T 014101061
Oltrttem ova 600 veto nominal Lint% tn one stmeture
E 1- and 2-family dwelling S Commarciallincluter101 1=1 ACC4:4150ry bulldhlg
Cif:Wilding over throo stories CiFeetles. 400 MPS Or more
0 MU10711111111 • maze builder II °d7,1 1:10cetipant inao ever 99 poisons 01'4(01 almaarrtia or
.. .
V 11111 1 v1•11• 4 :0 1 1i1 , Y1;011111::' 7 4 .',,' •i'"tiiip,''' Ilt4 - 4i,..ir 4 .!,, ClEgreseigliting plan RV pais
Clnadal.0111c facility
kb no.: b ads; 7975 SW Leiden LIMO • • - " • COME; ..,,—...--
Jo site dres
Submit a, 50t.s ofplime with any of Ma shove,
City/State/ZIP ! Tigard, OR 97223 . The Alava are not applicable lo %moray coonnieven scrvIce.
. . . .
.I!I 'll'IT1:'' li Ill ,IIiillit611. '' ii : lf,1: '-',Iitl'ilirl'ell 5. 'll , ..t•ii.:t;k 1 .:
SUIVI/h1dgispt. no.: PrOjtaat Millar !Aster Pert • I city. Pie Tow _ "
,. •,,,,,
CT01111 litrL'ethilrOCtiC .. all to job Site: New riaildentiai 'Ingle- or multi-fen* awaiting ilalt..
•
—•'• LICIIIW_.. j!!!,,__.2.1 .taaa
cp .—___.hasi a
. 1,040 skl_ ft. or less 145.15 4
_... ..
Subdivision: Leiser parK lot no. 1 013 ft Eu. add'1500, sq. or oott1011 OA° - 1 - ,
Mut insuti a tic Limited envoy, residential 7300 2
• Par" ....--.....
Limited .tm orgy, nanwerldential
- ,4';:li k'i - 1'' • i:ii• Ili!, i II •• 'Ill•l•'•:',,l, 'ill 10;'; ■li, ii5)1414.*OCTO :".413'140., ' . Each intinTeactursd or modular
_ dwelling, tended lindlor reader - 9190 2
•
— ._ Sarvicee or feeders lassounatio alterotion, andior reiocetion
300 an I or lein 50.30 2 ,t
ll'i'll•lli-rl; 41 ':: i2AI:l.iaaiZARRIl?1:1 q ■l 1 i.s lIN,l1 ;LIE ' . .1"ii ll,'"ll' li. ;MT.
• - , ii . • I , ,, 201 pupa to 400 amps E NM 10185 NN 1
- 401 amps co 600 a 4 IM 161160 2
Name ; Lend Homey • . . • . 601 anew to 1,000 °Mal II 240.60 111 1 '-
Acldrass: 12755 SW 69 4,eane,suite.m . o .
1,000 amlia all voile 454.0 1 ,
.
• Reoonnect only 66.113 2
City/State/ZIP! Portlaad, OR 97333 • omporin7 st Mica Or' Radon lastallationy alterstloo. soarer
.
Phone: (503)630.8800 - ' Fax: (503)508-8900 l l -' rsloessea
100 amps or leo 6615 i 1
Ownor lastallotiont hio installation is being nude on property that I Oviri Which is not - 201 1 170 t op am 100.30 2
ITaCtsdal 11)( sola, 1820e, TOM i2r oxcliange,,ocoorditig DOORS 447, 449, 670, oncl 701, - 401 Irmo 600 Imps 13.17s 2
owner signaturo: Date: . °roach *rants- inn% alteration, or assanalon, ear pond
; l i :) l It ' t ',. l.- .114 tif ' hi ; ;VI' l' ' is 'mix , , ,, SE,..1ioso.: - :.}1 , ill &Po for bmwt citowt$ with 1--
sorvine or feeder fon, nth 6.65 2
Susi pass nam .
e: Legend Homes • • branch oneutt
Contact nme • O. Foe An branch circuits
a; Peva Lucas
• • - ' withuid service or tbilai N41), 44,85 2
Address: 12155 SW 60 AveaueStitte 6100 cub inonch circuit
each Wel brooch await 6.65 _ 3
City/State/ZIP: Portland' OR 97213 . . ofireeneo us (service or hearaei Included)
phono: (503) 620-8080 Pate 1(503) 5984900 puma or irrigation circle 53,40 2
Sign or owl istss ilVISilla 53.40 -------- 2
S-moili slocasel • ' endhomog.00M • ' .. • .. . Signal eircaMir limited- ---
.
i ii• !ie. ', ii ,,:vi. 3,4 t ft N ;.iti„: W igiTSlrMill ll ll1,1,,:vo•;:t;.,, !,1, 1 !I :::111'llipli.h.,;t.,• oaorgi panel, alteration. or
- • extension. escribe: page 2 1
Business name'. Garner Elosurle -. .
Midwest 3930 SW 247P Avenue N A ... Each odditiosai Ins , «don over allowable In soy attic above
- pot inoection 6150
Chy/State/ZIPI VillsbOrts, OR 97123 Invest/ :... bon par hour ) ar min) 1111 6230
Phone: (sin) 591-1320 ' ' - •
• l 03)642.7 5 . •• - ' •
...is . 11=221=21=11111111111111Effill
_: - filmillig911111+
CGS Lie.: 121159 Bieettiea) • . .,•, . Lie; 3707-S Subtotal
Surtry, Electrician signature, rcquired: PI/ ' ' /
i fi liO r(''' ' ' ' ■ .P ... '....',.... ........7 .....'.."........../
NW TOVWW 0934 4r punt coo
- . -17. . .. -----
Siam surcharge (WA or Emit WO
Print mane; Date; 9/20104
........ : .. _
• TOTAL PERMIT nit
Alithorized tilstiosure: , Tow pavan lippIlsatim espies If d weds is nuesisTaloss0 wisidn 150 '
, dor OW k hoe boom eniepted as eavaptat•
Print norm: .
. roe mah000togy eel ay'rri-Counts Noittlina l'ulla Simi" heard
' " Nuttier 01 Per POMIC 1010
•
j01411Ainfitlquiviullne.tandthpp.bae 10103 44040111(1.0PCOM1W ES
. • •
. - --- - ,- -- -----
., .
• . . ., ' " '"—
a • • •
•
. . , .
• .
. ., ., . . •
• •
Mechanical Permit Application O,?;I arIZus OFFICE IISEIONL'Y;_, ,i r
City of Tigard Received
Permit ut No. y i1Jt /V
13125 SW Hall Blvd., Tigard, OR 97 1�'ns . C , 1.� s I VE Plan Review (
Phone: 503.639.4171 Fax: 503.598.' 9i1 Other Permit:
Date /By:
Inspection Line: 503.639.4175 !iJ. . Date Ready/By: lurir El See Page 2 for
-�� Supplemental Internet: www.ci.tigard.or.us SEP 21 200 Notified/Method: Su � lemental Information
' o ` tb� i °' COMM RCIAL'FEE*SCiiEllU E — IISECH ECKL�ISTr
' � Q �� � . .. .€ ( � � i ., - — ....._.�....� �... �..
® New construction El Ydtti/"alt�fiiTtt�gtrtent 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.
" CATEG r Value $
g„ = ORY OF CD4* CTION „ . „ ; _
RESIDENTIAL ; Q U1PM EN
T / SYS�TEMS FE
ES* ., fe
® 1 and 2 family dwelling El Commercial /industrial El Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
'tr Li " ".JO S I T E INFO AND'LOCAi . 4 y; Heating/cooling
Air conditioning or heat pump
Job site address: 7975 SW Leiser Lane (requires site plan showing placement) 14 00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU.(ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Leiser Park 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 -
SuiiuivisiOii: Leiser Park - Lot no.: 013 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
r _, a W Water heater ]
-: N ADESCRIPTTON OF � RI�' � �. - m m. - t r � Gas fireplace 10.00
z.: <.. _
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 10.00
.� g PROPERTY OER .. `` ❑ _ TENAN=T .
-. � .,... " _: Other: 10.00
Nance: Legend Homes Environmental exhaust and ventilation
Range hood /other kitchen
Address: 12755 SW 69 Avenue
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
:; APPLICANT CONTAC " PERSON' ; '4 Attic /crawlspace fans 10.00
.
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 Range
�r ° " F' C ON RAGT®R: it ;0 t s Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 Clackamas River Drive .1 1. „ :. m H -' .. ?!P ` ._ -61 .;
, MECHANICAL PERMIT °FEES to W i *'
City /State /ZIP: Oregon City, OR 97045 Subtotal
Phone: , (503).557_2220 Fax: (503) 557 - 0919 Minimum permit fee ($72.50)
-- Plan review permit
lie.: 72623 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized si Itature: This permit application expires if a permit is not obtained within 180
g days after it has been accepted as complete.
Print name: Steve Lucas Date: 9/20/04 * Fee methodology set by Tri- County Building Industry Service Board
•
i:\ Building \Permits \MEC- PeimitApp.doc 12/03 440 -4617T (I 1 /02 /COM /WEB)
Plumbing Permit Application / Received , -,; G z .4 +. , FORt ; OFFICE,VS.E O ?� mad o _
City of Tigard EV�� V �/ ..,...1";.::,'•‘1.-4,,
Permit No.yx S 7/9dt f - 'i4f
13125 SW Hall Blvd., Tigard, OR 972 3 Plan Review fir/
Phone: 503.639.4171 Fax: 503.598.1960 ' t* I w I Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 SEP 21. 2 U _ - - o! - , Date Ready/By: 3 °'''S See Page 2 for
Internet: www.ci.tigard.or.us J 1 � Notified /method: Supplemental Information
T (/'±�� Noti /Met b��
rE' '� - y �� / ((�� ..':0' >' r,\Ifs,. �' w ,,, . "€ ..." -J "•�iff'S'.d 1 Ru
°' / N� ' ._.:��'��% - TY1'E���TW �`.�F� m,s � F� x�' �� . � IEEx�.. SCHEDLILE ^_ � �g
_ -; ��'u*xt...�v�<. �,�-� �, =��i'. �= ,.k :fit� 6r �� " pp '� y _ � =, L �r I� � _ �� �sl�, �.... - � =r� �� s�: +4�` s,:,z�a- �±�z:!�m,a�,i�'�+. n. . ,. _��. „�.. ..�
B UIL 1 � � � ° For special information use checklist.
® New construction emolitton
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY-WOF" CONST1RUCTION ;=rf SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building I=1 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
I Fire sprinkler (_ sq. ft.) Page 2
B SIT I ORMATION - AND LOCATION ,
i JO ti Site utilities
Job site address: 7975 SW Leiser Lane Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Leiser Park 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: Leiser Park Lot no.: 013 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: -_ i
i`� � O F : WORK 1. -
Absorption valve 16.60
o
"� .a ,a., ?� , „ ti :, - � _ ate. � . . ,' . 3 ,.. Backflow preventer Paget
Backwater valve 16.60
I Clothes washer 16.60
Dishwasher 16.60
� Drinking fountain 16.60
.. '.. ® PROPS A'WER
VO 1 g ❑TEN /ANT'
Ejectors /sump 16.60
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
'`. nt... PPLICANT " o .," "_ t N TACT PERS®N Hose bib 16.60
�. ,. _ . ; - ®A � _ :. _n . �. , _�� __�� � .. , ;�� � ,._- Ice maker 16.60
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;Statc/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
-,/ ` GONTRATOR ,;'
?s Water closet 16.60
Business name: Wolcott Plumbing Water heater 16.60
Address: P.O. Box 2007 Other:
Subtotal
City /State /ZIP: Gresham, OR 97030
Minimum permit fee: $72.50
Phone: (503) 667 - 1781 Fax: (503) 667 -9891 Residential backflow minimum permit fee: $36.25
- CCB Li 23847 - Plumbing Lic -no - : 26 =208PB - - - -Plan_ review_(25 %_ofpermit fee)_
State surcharge (8% of permit fee)
Authorized signature� TOTAL PERMIT FEE
Print name: Steve Lucas Date: 9/20/04 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by 'Fri-County Building Industry Service Board.
i.\ Building \Permits \PLM- PermitApp doc 12/03 440- 4616T(I0 /02 /COM/WEB)
/ f aC i -G /
�, kAkAAA`AAAAA A AAA `AAAAAAAAAAAAAAAAAAAAAAAAAA AAA
2 1 .
3 p
6 I
•
1 STREET TREE CERTIFICATION rt. g
•
• n
AI S I, RoiDAJE At \ e�xt for /.470/1-_ //0171,--.5 fi
tri .4
z (PLEAS FRAwn, LRMIT'HOLD ,� i
I A
Q : : i
EL.li 11, • Do hereb I location * I ► co
4 1 meets 4 , - :.:u ? on ounty 0
land use and development standards for street tree installation. i ►
4
•
• I:
• ADDRESS: 4 S 14#1 --
,02 A iti
1 LOT: /3 SUBDIVISION: fi -f S C v � V/ _ • FS
•
4 • N
4 / _ /
jj//
I BY: / 1 zA it DATE: zz 0 5
__..ii ' , ______ l I I: * 1
in A
1 RECEIVED BY: DATE: --- - ��
•
PVVVVV7VY7VVVVYVYYYY VYYVVYVVVVVYYTYVV 'YVVVVYVV7VVVYVVVVN
c.
o
irki
CITY OF TIGARD ' 0
ty) sy
BUILDING DIVISION PERMIT #: a,W (f—ZJd Z S-(
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �°iNjnpq�gti
Inspection Requests (24 Hrs.): (503) 639 -4175 ,..'_W __..
INSPECTION WORKSHEET FOR DATE: ✓ - 9 TIME: PAGE:
SITE ADDRESS: 7 7 J CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #: 2) —33 70
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions: -ji ,:•• 7 - / .
' lei,. �=.lr.. , -
vr
/ /
„Al re --1,01411 • - - - ' - , , _ . 4
7 - ...--7--,_-- 6 -
1, r / ? 6)
•
_ _ _PASS __ PARTIAL_AP_P_ROVAL 0 CANCEL__ ___— I_.I_NO_ACCESS _
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: ,--) Phone #: (503) 718-
CITY OF TIGARD „
BUILDING DIVISION - PERMIT #: MST2004 -00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2004
Phone: (503) 639-4171 � °
Inspection Requests (24 Hrs.): (503) 639 -4175 °` -..
INSPECTION WORKSHEET FOR DATE: 3/24/2005 TIME: 7:09AM PAGE: 76
SITE ADDRESS: 07975 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 013 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF
OWNER: LEGEND HOMES, PHONE #: 503-59B-B900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 3/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002617-12 503- 209.3370 N
Corrections /Comments /Instructions:
i —, , 1 : R/ v4'
_PASS ❑_PARIIAL_AP_P ❑ CANCEL _ •
❑ NO ACCESS a
❑ FAIL ❑ CALL FOR INSPECTION ' ❑ ADDITIONAL FEES ASSESSED
Inspector: C y'/ 4 y /L A--//
-% Date: 0 7 U,, Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00281
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/13/2004
Phone: (503) 639 -4171 1 .'# 1 I // �oqi� j 1l'I " �
Inspection Requests (24 Hrs.): (503) 639 -41751
INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7:07AM PAGE: 13
SITE ADDRESS: 07975 SW LEISER LN //LOT CLASS OF WORK:
SUBDIVISION: LEISER PARK #: 013 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF
OWNER: LEGEND HOMES, PHONE #: 503 -598- -8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 002863-10 5503209 -3370 N
Corrections /Comments /Instructions:
•
V S _ El CANCEL_ _ ❑_NO_ACC
❑ FAIL MI CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ �� Date: 5 Phone #: (503) 718-
. -
CITY OF TIGARD
ill. -4 1
BUILDING DIVISION PERMIT #: MST2004-00281
1125 SW Hall Blvd., Tigard, OR 97223
A 1 0/ DATE ISSUED: 10/13/2004
Phone: (503) 639-4171 z ovioviiill'I'\
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/25/2005 , TIME: 7:07AM PAGE: 14
SITE ADDRESS: 07975 SW LEISER LN , CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 013 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF
OWNER: LEGEND HOMES, PHONE #: 503-598-8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620.8080
Inspection Request Scheduled For: Date: 3/2512005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 002863-09 503-209-3370 N
Corrections/Comments/Instructions:
USA-
:7--p_c-5 Ce..._771, 1" --------- ,
'1-
•ff--
4
a
w
_ _
I PASS ri PARTIALAPPROVAL D_CANCEL ri NO-ACCESS _
[1] FAIL 11] CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
//
Inspector: A Igrai■ Date: 3 Z ne #: (503) 718-
1 111
_ _