Permit U RIM ' MASTER PERMIT
A lio CITY OF TIGARD PERMIT #: MST2004 -00280
,Itliii?' DEVELOPMENT SERVICES DATE ISSUED: 10/22/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
SITE ADDRESS: 08015 SW LEISER LN PARCEL: 2S112BC -14200
SUBDIVISION: LEISER PARK ZONING: R
BLOCK: LOT: 011 JURISDICTION: TIG
REMARKS: New SF / House burned and was removed. Permit reissued with same plans. All inspections prior
to Jan 3, 2005 are for the original structure.
BUILDING ,
REISSUE: LP011 -Al STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.358 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,470 sf GARAGE: 672 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THROE sf RIGHT: 5
VALUE: 277,550.60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,828 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: 4 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: 5 201 - 400 amp: 201 - 400 amp: 1st 1MO SVC/FOR: 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 +amp3- 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: DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,827.45
This permit is subject to the regulations contained in the
LEGEND HOMES LEGEND HOMES CORP
LEGEND D 69TH AVE 1 LEGEND D HOMES
AVE R Tigard Municipal Code, State of OR. Specialty Codes
12755 PORTLAND, OR 97223 TIGARD, OR 97223 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 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 8: 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 Foundation Insp Underfloor insulation Plumb Top Out Shear Wall Insp Gas Fireplace
Sewer Inspection Post/Beam Structural Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Insr Insulation Insp
Footing Insp Post/Beam Structural PLM /Underfloor Electrical Service Exterior Sheathing Insr Rain drain Insp
Footing Insp Post/Beam Mechanical PLM /Underfloor Electrical Rough In • Low Voltage Rain drain Insp
Foundatio _ _ _ Post/Beam Mechanical Mechanical Insp Framing Insp Gas Line Insp Storm drain Insp
Issu d By : ■ / 4.0 • iL _ %_ Permittee Signature .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next busines day
: C ITY OF TIGA MASTER PERMIT
PERMIT #: MST2004 -00280
Z l IV' DEVELOPMENT SERVICES DATE ISSUED: 10/22/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 08015 SW LEISER LN PARCEL: 2S112BC -14200
SUBDIVISION: LEISER PARK ZONING: R - 4.5
BLOCK: LOT: 011 JURISDICTION: TIG
REMARKS: New SF
BUILDING
REISSUE: LP011 -A1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.358 sf BASEMENT: st LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,470 sf GARAGE: 672 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 TURD: sf RIGHT: 5
VALUE: 277,550.60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,828 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: 4 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVOFDR: 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 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: LANDSCAPERRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,702.45
LEGEND HOMES LEGEND HOMES CORP This permit is subject to the regulations contained in the
L Tigard Municipal Code, State of OR. Specialty Codes
12755 EGE D HOMES
PORTLAND, 69TH AVE VE TI 12755 LEGEND HOMES
755 SW 69TH H AVE AV #100 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 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
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /S In utN
.! 11 116,
Issu - : c : ! :/ _ - . .t / Permittee Signature : ��
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
•
Building Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Date/By: 9 ,„Z. Permit No. 'S:20oC 002
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598,,1268 Date/By: Other Permit:
5 U) 1 � _ �,� ���� Ready/By: o y M _ da��o�
Inspection Line: 503.639.4175 2004 ^ Date t �� G , See Attached Information
for
Internet: www.ci.tigard.or.us Notifie ethod: 7 Supplementallnformaion
CITY OF TIGARD
t�U��>�'t�N REQUIRED DATA: 1- AND 2- FAMILY DWELLING
• ® 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $276,699.00
® 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms: 4
❑ Master builder ❑ Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 8015 SW Leiser Lane New dwelling area: 2831 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: COMMERCIAL -USE CHECKLIST
Subdivision: Leiser Park I Lot no.: 011 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT 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:
® APPLICANT ® CONTACT PERSON NOTICE
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
Arkin-As: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97223
apply:
appicant is exempt from licensing, the following reasons
Phone: (503) 620 -8080 X 9.4 t Fax: : (503) 598-8900
E -mail: slucas ®Iegendhomes.com
CONTRACTOR
Business name: Legend Homes BUILDING PERMIT FEES*
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 lic.: 060563
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
•
Print name: Steve Lucas I Date: 9/20/04 * Fee methodology set by Tri Building Industry
Service Board.
i:\ Building \Permits \BUP- PcrmitApp.doc 12/03 440.4613T(II /02/COM/WEB)
11/04/2002 05 6427925 PAGE 02
�1�1 FAX N0. 5035988900 P. 03 • n Eg SEP-20 -2004 ititASC Yelp
•
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13125 SW Hell Shod., 410tIrd, OR )17213 R ul P
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• ® New CoeStluolitin • • ❑ Addltion/eltaradoahoplaoenlent Piano nee . .. •
[Amigo over 225 earn, crawl ❑ Haz(wdeut location
❑ Demolition ■ Rim .... �
8nviee over 320 ntctn ❑9uildng over 10400 eq. It,
t •run an .1 and ,•• i i i t • d el !trl ,I �� 1.. n ,I" 'M I •1� c ' et' .,m S rive i 15
a 1 I:; tf� �I �' 1 . ! t l of 1 -and 2-farrily dwolIInge 5 4 or more new maidcntial
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IS I- end 2 -Rmi1y dw ill% ■ Colnf:Setei6YinduIMnl ■ Accessary building neyilem over 600 volts nominal unlis In nano stractaro
bilging am Ras Sarin C Foodote, 400 amps or worn
��yy■ Multi-Emil ■ tyeaf builder S Oche 7� 8Ocou ;ant ioaJ ova 99 gamma Mtn► +� nt
antennas or
1� f ; w,� 1Ih.�,'l iii u i l .ir .'��riAI�iJ3 Pik DABrosMlghtlrQ plan AV park
C n teldleare lboi ity ❑Other: _____._____
Yob no. Job site addraaa: 8015 SW Leiter Lane Submit lien of plum with arty of the above.
City /State/ZIP: Tigard, OR P7333 1'he above are rot epplleable to toroporary construction service_
ill d::a °
Stltte/bWgigt no.: Prefect name: Leiter Park [ ' rer.
Crone itr et/dircctio na to Job pine;; env rtideaei.l sin or nwittdamlly do ' Y unit.
tecodes aritobod •;_s,
1.000 .. a. or Iwo gm 145.15 r ICU
Subdivision :1440r Perk __ • • I Lot no.: 011 Ea. ode SOS • . R. or till NM 33.40 11111111.111 - 7J,cq U
'Cox map/pawl n0.; � � ��� idmlwd energy, nomrottdential � 73.•00
II I � fgmteICPrIIi 1 °�R.. a , 11..1.. ,.'t,. . fa:J. ". ;! ? %K u. ! f,Vi ', "il' 1. Each tron 11'edtuted or rxeckdoT
Srr ion or Masers instal .. alterntioea andWnr reloatioa
200 amps or less ■ 80.70 2
ly 1%•= - ;•w: tu-N4, I I k ' 1 1 L ". 11I4 J; '
1 ii ; l . .. 7 Iii ' i ri 201 •110400 •a 100.D5 2
:..o � ' tJ,iil:l . . ... t' ■I!r, , i ., • .: • .,. :...L. ,• Iu: i I': e s sr,.. 403 ems W 400ands 160.60 2
Nemo: Legend Homes 601 Iowa to 1.000 • .• 240.60 a
Addrcss:13755 SW 69`e Avenue, Suitt P mom Over 1,003 oa arvolts 494.65 2
_I 2
Cfty/5tam/ZIP1 Poniard, on 97113 7htnpraryacrvtsos recent tentnllsnen, attaratlo., andlar
Phone: (503)620 - 9050 Pax' (603)5981 - 8900 r we
amps or kra 60.13 1
i ser aolgilatlon: l6 itzetal en on 1. • erns made on property 1 at I own which it not 201 pm to 400 it 100,30 2
inccnded for solo, iosoo, rent, or oxchous% o cording to ORS 447, 449, 670, old 7511, 401 amps to 600 amp 133.75 i 2
Owner rigaature.0: Dose: Branch detain - oar, oltoro0bL or exteodon._ et pond_
LI '':i�i.M�i i' " N • ' • '` A- N e far breach elrolltr with
savies or Wain tee, nab 6.65 2
Main= name: Legend Rome. branalt circuit
8. Foe for branch Omuta
Cotten raps: Stews Luau wpaow service or reader am, 46,85 2
Addreaai 12755 SW 69 Avenue, Sahe 11309 each b h elm* Gogh 419 Nandi eircait 6.65 - L 3 .
C ity/Stato/ IA Portland, OR 97223 Mbtaltsnvoar 4)
Revoke er feeder nos losesda
Photo: (507) 6204080 Fax. 1 (803) 5994900 pump cm iwiladan oinks 53.40 i 2
Sigr1 or outline lighting 53.40 2
J„ ; . . 1 , mOLCOM Stew oircoii(s) or limned•
, 44.11 . 41•ii , •:. i;' - , inummimailpfirmilligismaisomm energy pone), °ilenfimA or 2 2
cxponnon. DoOCrlbe: Page
Diminvae n.met darner el orris 1 f
Addrmo: 2920 SW 247 Avenue d A Sosh additional inupoctlon over allowobto totoy of rbo *bora
Por inspection 62.80
City/State/72P: 111IiabOre, OR 97113 5+vsstiaatim. , hero t M.o. 6340
, Phone, (803) 5914320 ',.. - ' •) 6421193 industrial . .apt new f
;mil, sr; ''=-•.::l.r,- j : = re
CPS Llc.1 121139 Electrical 1..lc - ie.: 3707,E Subtotal __
1 ...... -
Suprv. Slovtria .7../1.1117/7411111111111
an signature. required: 9 11 11 r eview (3515 of pan i Aro)
Print name: pats: 91711104 Seats uwchor s (8%o<permit ire)
. — TOTAL P8RMIT PIS I
Authorked elgnefure: 'the• WWI i.P I a ins swim - de pe ennb not owned anode 180
Bari attr► It 4111 bow ecOgtoe as ewrybm
Print ROME - . .Dat • Fa methodology sob) Tri-Cotme• Bulging fedowy Barks Beare
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•
•
Mechanical Permit Application FOR OFFICE USE ONLY
City at Tigard ve
RECEIVE; Received
Date/By: ecve
Permit No 5rg
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 /� is Datc/By:
, l
Inspection Line: 503.639.4175 1 i 1 f l l I I Date Ready/By: saris ® See Page 2 for
Internet: www.ci.tigard.or.us SEP 2 1 Notified/Method: Supplemental information
CITY OF TIGARD
TYWRFOTIVEtiDIVISION COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
® 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.
•
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 8015 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
Subdivision: Leiser Park Lot no.: 011 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK 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
® PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: 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 ❑ CONTACT PERSON 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
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 Clackamas River Drive MECHANICAL PERMIT FEES*
City/State/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) - 557 -2220 Fax: (503) 557- 09.19__ _ — — 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
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- PcrmitApp.doc 12/03 • 4404617T (11 /02/COM/WEB)
Plumbing Permit ED FOR OFFICE USE ONLY
Received
Date/By:
Plan Review City of Tigard Permit No � �
`(- 4
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.19SEP 2 1 100 G rnrx t I plan Re : Other Permit No.:
24- Hour Inspection Line: 503.639.4175 _ J E` + Date Ready/By: LLms El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGAR . """°° "'''' Notified/Method: Supplemental Information
elt.M.DnedaiNISION FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- 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:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 8015 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.: I 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.: 011 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
® PROPERTY OWNER ❑ TENANT
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
® APPLICANT Hose bib 16.60
❑ CONTACT PERSON
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/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
CONTRACTOR Water closet 16.60
Business name: Wolcott Plumbing Water heater 16.60
Address: P.O. Box 2007 Other:
City/State/ZIP: Gresham, OR 97030 Subtotal
Minimum permit fee: $72.50
Phone: (503) 667 -1781 Fax: (503) 667 -9891 Residential backflow minimum permit fee: $36.25
CCB Lic.: 23847 Plu L no.: 26 -208PB Plan review (25 % -of permit fee)_ _ _
State surcharge (8% of permit fee)
Authorized signature: � A- • TOTAL PERMIT FEE
I 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 Tri-County Building Industry Service Board.
............. g'^cmmits i'LM•PermitApp.doc 12/03 440- 46I6T(10 /02/COM/WEB)
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CITI' OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO: MJ'S2_DI V A01,R)
PUBLIC WORKS:
Street Trees: ❑ Approved 0 Not Approved
Protected Trees: ❑ Approved ❑ Not Approved
By: Date:
Notes:
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: \\,.51
,„1O6i9 n'Oen'4
PLANNING DIVISION: y •.5°
Required Setbacks: Approved ❑ Not Approves!
Side: 5 Street Side: _ 1
Front. __ Garage: _ Rear: IS
Vknal Clearance: Approved ❑ Not Approve.:
M axu utm Buildint! Height. AO
' • •; cinvi.' nrwider Letter Required: ❑ Yes '4 No
i ❑ Received_
{ = _C!. u_ Date: °� -43 -o
ENGING ING DEPARTMENT:
Actual Slope:....% ig Approved ❑ Not Approved
Site Plat / r Er Approved 01 No Approved
B : `� !�' Date: `/ 2 C
Notes: - PO paled /ag- er —eual, -rw,s l`-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: M ST2004 -00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2004
Phone: (503) 639 -4171 . 4 24 0 l l�� i �
Inspection Requests (24 Hrs.): (503) 639 -4175 ��� L.
INSPECTION WORKSHEET FOR DATE: 5/16/2005 TIME: 7 : 09AM PAGE: 8
SITE ADDRESS: 08015 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 011 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF / House burned and was removed. Permit reissued with same plans. All inspections prior to
Jan 3, 2005 are for the original structure.
OWNER: LEGEND HOMES, PHONE #: 503 - 598-8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620.8080
Inspection Request Scheduled For: Date: 5/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 006962 -02 503-209 -3370 N
Corrections /Comments/ Instructions:
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r I • ?A _ ❑ PARTIAL APPROVAL -- 0- CANCEL -- ❑ NO ACCESS
�� �'� ^IIL ❑ CALL FOR INSPECTION
❑ ADDITIONAL FEES ASSESSED
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Inspector: /! Date: 5---46, � ' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00290
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2004
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/25/2005 TIME: 7 :12AM • PAGE: 13
SITE ADDRESS: 08015 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 011 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF / House burned and was removed. Permit reissued with same plans. All inspections prior to
Jan 3, 2005 are for the original structure.
OWNER: LEGEND HOMES, PHONE #: 503-598-8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: 5/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007717 -04 603-209-3370 N
Corrections /Comments / Instructions:
PASS ❑ PARTIAL APPROVAL ___ ❑ CANCEL ❑_NO_ACCESS_
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ;jam'"�' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MST200400280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2212004
Phone: (503) 639 -4171 , el ov eh,,_
Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: 5/25/2005 TIME: 7 :12AM PAGE: 14
SITE ADDRESS: 08015 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 011 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF / House burned and was removed. Permit reissued with same plans. All inspections prior to
Jan 3, 2005 are for the original structure.
OWNER: LEGEND HOMES, PHONE #: 503.598.8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620.8080
Inspection Request Scheduled For: Date: 5/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 007717 -03 603-209 -3370 N
Corrections /Comments /Instructions:
e • AuCe +0 '0,r,,.rti, ,., r=/ ,v 44 _ CA, ef--r A.16 4'7% 1 sSv zzS
PASS ❑ PARTIAL APPROVAL _ _ ❑ - CANCEL ❑-NO- ACCESS - - -- -
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:` Date: 5 zs Phone #: (503) 718-
CITY OF TIGARD `
BUILDING DIVISION - PERMIT #: MST2004 00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27J2004
Phone: (503) 639- 4171 I I�
Inspection Requests (24 Hrs.): (503) 639 -4175 ..414. - 5 'I I-.
INSPECTION WORKSHEET FOR DATE: 5/26/2005 TIME: 9:23AM PAGE: 4
SITE ADDRESS: 08015 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 411 TYPE OF USE:
PROJECT NAME: LEISER PARK
DESCRIPTION: New SF 1 House burned and was removed. Permit reissued with same plans. All inspections prior to
Jan 3, 2005 are for the original structure.
OWNER: LEGEND HOMES, PHONE #: 503.598.8900
CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080
Inspection Request Scheduled For: Date: W27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 007848.09 503 - 209.3370 N
Co rrections /Comments /lnstriactions: V` 6-1)---- 1
( A Gt--c_ji PASS ❑ PARTIAL APPROVAL - -- ❑ CANCEL 0-NO- ACCESS ---
❑ F A IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C� l_ / Date: S/ 0 #: (503) 718 -