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12165 SW AMES LANE —
MASTER PERMIT'
CITY CSF TIGARD PERMIT #. . . . . . . : MST96 -01 ""a
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/17/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL: 2S110I3B--04lZ100
_'TTT_ ADDRESS. . . : 12165 SW AMES LN
I !1iDIVISION. . . . : ARLINGTON RIDGE ZONING: R--3. 5
13LLJL 1 . . . . . . . . . . .. . . . . . .. . . . . . .
Remarks: PATH I
---------------------------------------------------------------- BUILDING ----------------------------------------------------- --
RE
----------------------------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.:NEW HEIGHT........: 23 FIRST....: 1497 sf GAR4rk..... 768 sf LEFT..........: 7 SMOKE DETECTRS: Y
TYPE OF USE...:9F FLOOR LOAD.... 40 SECOND...: 1899 sf FRONT.........: 20 PARKING SPACES: I
TYPE OF CONST.:5N DWELLING UNITS: I FINBSMENT: I sf RIGHT.........: 45
OCCUPANCY GRP.03 BDRM: 4 BA1 H: 4 TOTAL------: 3396 sf VALUE..$. 232716 REAR..........: 56
-------------------------- ------------------------------------ PLUMBING ---------—------------------------------------------------------
SINKS.........I I WATER CLOSETS.: 4 WASHING MACH..: I LAUNDRY TRAYS.: I RAIN DRAIN ft: 0 TRAPS..,......: 0
LAVATORIES.....- 5 DISHWASHERS... I FLOOR DRAINS.., 0 SEWER LINE ft: @ SF RAIN DRAINS,. I CATCH BASINS..: 0
TUB/SHOWERS...: 4 GARBAGE DISP.. I WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PREVNIR: I GREASE TRAPS..: 0
OTHER FIXTURES: 0
--------------------------------------------------------------- MECHANICAL ---------------------------------------------------------------
FUEL TYPES----------- FURN ( 160K @ BOIL/CW ( 3HPi 0 VENT FANS.....: 5 CLOTHES DRYERS: I
/GAS/ / / FURN )=I@*. I UNIT HEATERS..: 8 HOODS.........: I OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: I WOODSTOVES....- 0 GAS OUTLETS...: I
------------------------------------------------------------ ELECTRICAL --------------------------------------------------------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ---- --ADD'L INSPECTIONS—
IM SF OR LESS: I @ - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADDIL 5005F.: 6 201 - 480 amp..: 9 201 - 400 asp..: i 1st W/O SVC/FOR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: o
LIMITED ENERGY.- 0 401 - 600 alp..: 0 401 - 600 amp..- a EA ADDL BR LIP: I SIGNAL/PANEL...: 0 IN PLANT......:
W HM/SVC/FDR: I bal - IM alp.: @ 60I+a1ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ------------------------------------ PLAN REVIEW SECTION --------------------------------
Reconnect only.t 0 )r4 RES UNITS-: SVC/FL. z225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:_
--------------------------------------------------- ELECTRICAL -- RESTRICTED rNERGY ------------------------------------------------
A. SF RESIDENTIAL--------------------------- 8. COMMERCIAL——--------------------------—-------------------------------------
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: X BOILER.........: HVAC...........: LANDSCAfIr"IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........t INSTRUMENTATION: MEDICAL.....,..: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS...... TOTAL 0 SYSTEMS: 0
Owner: --------------------------------------Contractor: -------------------- TOTAL FEES:$ 5002.26
RANDY RADCLIFFE RANDY RADCLIFFE
17292 SW ARKENSTONE DR 17292 SW ARKENSTONE OR
TIGARD OR 97224 TIViriD OR 97224
Lrar-, #: 620-7397 Phone #: 721-1864PAGER
Reg C.: 45205
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all .cher
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.
-------------------------------------------------------- REQUIRED INSPECTIOW- --------------------------------------------------------
Footing
-------------------------------------------------------
Footinq Insp PLM/Underfloor Shear Wall Insp Insulation 1.1sp Appr,'Sdiolk Insp Erosion Control
Foundatilln Insp Mechanical Insp Low Voltage Gyp Board jip Electrical Final
Post/Beam Struct Plumb Top Out 'Fireplace Insp Rain drain Insp Mechanical Final
Post/Beam Mechan Electrical se;vi Gas kine Insp Water Line Insp Plumb Final
Crawl Drain Framing Insp /i Gas Fireplace Water Service In 11,41ding Final
v,er-mittee '_-jigtiatul e Issued ]BY
Gall for inspect .Lon - 639-4175
SEWER CONNECTION
CIT` OF T I GARD PERMIT #. . . . .PERMIT
. . : SWR96-0171:-:'
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/ 17/96
13125 SW Hall Blvd.Tigard,Orogon 97223*61f0 (50')639-4171 PARCEL: 2SI10BB-04000
31TE 14DDRESS. . . : 12165 SW AMES LN ZONING: R-3. 5
SUBDIVISION. . . . : ARLINGTON RIDGE
BLOCK. . . . . . . . , , LOT. . . . . . . . . . . . . .017
I'ENANT NAME. . . . .
USA NO. . . a * . . . . . : FIXTURE UNITS. . . 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : I
JYPE OF USE. . . . . :SF NO. OF BUILDINGS: I
INSTALL TYPL. . . . :BUSWR IMPERV SURFACE: 1,
Remarks! PATH I
OwnersFEES
RANDY RADCLIFFE type amount by date t•ecpt
17292 SW ARKENSTONE DR PIRMT $ E,200. 00 JMH 04/17/96 96-278337
INSP $ 35. 00 JMH 04/17/96 96-278337
TIGAPD OR 97224
Phone #: 620-7397
CONTRACTOR NOT ON FILE
Phone #t $ 2235 00 TOTAL
Reg #. . t REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspqcti n
of the Unified Sewage Agency. The permit expires IN days from
the date issued. The total amount paid sill 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 shall prospect 3 feet In 11 directions from
the distance given. If not so located, the Ialler shall purchase
a "Tap and Side Sewer' permit and the Ag Ill install a lateral,
Permittee Signatl.tr-e :
rv,&
Issued Byl -------
Call fo,.- inspection 639-4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: �r' S S�-� f I WY Lan�,
Office Use Onl
Subdivision: ��].�f;�.: .•., I���� Lot# 17
j ` Contact Date _ / / _Initials _
Valuation: �,�J< C z'c' _ Result
New Construction Only: (Square Footage) Planck/Rec # _
Permit #
House --_;�J`r = Garage T�� _ Reissue of
Map & TL #
Corner Lot? ;Y N Flag Lot? Y IN Zone y
C Plat # -
1 �
Owner: -
! Approvals Required r _�
Address: s i `r t- S c�,' Ark eol s o i f c7[.
Planning Setbacks, Solar >
172-ZY Engineering
Other _
Phone: 1= 1- `'. -)V 7
Items Required
Contractor: _ ��_►<<��+i �...�`�► �-
Subcontractors _
Address 1.722`} z `���' r�� e�.�s '•�a Truss Details
Other
Notes
Phone:
Contractor's License #
(attach copy of current Or g Iigense)
r',ontact Name �_t A, I,
Contact Phone i 1 ) CLC
Subcontractors: / �� ;� Architect/Engineer: _ctvi uc, ILA-1VI ►'n
GI
.CLY♦'CAL, //I
dACIGYI
rsc .T.t`�Ctl✓'. '`�
Plumbing: 1 rC>< ' Address S! = }_ IT r' Sv. z�•t
Mechanical r.y Il PftA-J,.rl __ -_ A
(attach copy of current 0& Contractor's License)
Phone: ( 'jZ 5? l .'4.4yi•E,L
JOB DESCRIPTION: ( '• �� L C Lis —
111
_ l�J_ l.St i 4'ZC- J3S7
Applicatif mature Applicant Phone number
Received by: 11 _ Date Received. __ �'
Permit S Accuunt Description Amount Amt Pd. Bal. Duo
`r,V• - ' ) SIdg. Permit (BUILD)
Plumb. Permit (PLUMB) c�°
Mach. Permit (MECHI
C'I_L
8 � < u
Bldg: . �'h l b. G=� %e'
Plumb: ( 1
Mach: '� 1 U
Plan Check 1 (PLANCK) 51
Bldg:
Plumb:
.,Aech:
Sewer Connection (SWUSA) l' ,1• `
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) 1C''Sr? � f ) J
Residential TIF (TIF-R)
Mass Transit TIF (TIF-,%M
Commercial TIF (TIF-C) _
Industrial TIF MF-I)
Institutional i1F (7F-IS)
Office TIF (TIF-C)
'Nater Quality jWCUAL)
'Nater Quantity ('NQUANT) Lr _ C L;
Fire Life Safety (FLS)
Erosion Cntri Permit (ERPRMT)
Eresion Planck/USA (ERPLAN)c
. sion PlancklCCT (ER /
CSN) t�
J
OITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
CERTIFICATE OF
OCCUPANCY
-FRMI t ii. . . . . . . c MST96-0178
DATE: ISSUED: 10/03/96
PARCEL: 2S11ODS--04000
I TE ADDRESS. . . a 1 :165 SW WMES LN
SUOUIVI5ION. . . . a ARLINGTON RIDGE ICININGaR•-:3.
SLiICK.. . . . . . . . . . t LOT. * . . . . . . . . . . . i01.7
..ASS OF WORK: , o NE;W
PE OF USE. . . a SF
PE OF CONSTR e 5N
�CUPANCY C-PP, -R3
'lJr~1ANC Y L.OPD :2
marks " PA711 I
Anera
144DY -•'4Di:l-IFF-E
,'292 SW ARKENSTONEi DR
! BARD OR 97224
r one #-. 620-•7397
ontroctorc
6aNDY RADCLIFFE
129i? SW ARKE:NSTONE" DR
DARD OR 97224
sone #c 722 -1.8E�4PACj R
.,g #. . : 45205
1 is Ger-tific+mte yrantcj occupancy of the above referenced building o► portion
•rereof and confirms that the building haf been inspected or compliance with
ire State of Oregon Eipeciatlty Cosies fr r ' lie prom occ.upanc and ume under
iiich the referenced permit N.as i%%ued- 1
�qIILI)ING INSPECTOR LU y.p3 8 Fr ICIAL
POST IN CONSPICUOUS PLAC'F
'_-~- -
�
�
|
/
|
/ 7355 SE JOHNSON CREEK BLVD PRMT $ 15. 00 TAT 10/10/96 96-28504
� '
City of Tigard PLUMBING PLi-tnni t APPLICATION Planck/Rec. #
13175 SVJ Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
+-»•r�+.�+
Now single Family Residences Only
�•••• 0 1 BATH HOUSE$140.00 0 2 BATH HOUSE$195.00
Job '���� !'r) 1 r 0 3 BATH HOUSE$225.00
Address Fee Includes all plumbing "too In the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer, See fees below.
FIXTURES QTY PRICE AMT
Sink 9.W
wrp Ad*vN ^�^� Lavatory 9.00
Owner A Tub or Tub/Shower Comb. 9.00
ahrwr. Shower Only 9.00
Water Closet 9.00
W■.+...r Dishwasher 9.00
Garbage Disposal 9.00
Orrnpant �•• Weshlnq Machine 9.00
Floor Drain 9.00
tlr+a• -` t► Water Heater 9.00
Laundry Room Tray 9.00
--- -- Urinal 9.00
i I > Other Fbdures (Specify) 9.00
900
Contractor -
I i 1 9.00
9.00
Sewer 1st 100' 30.00
ft-R..•.~ Cr 0-'•"• Sewer-es. AddIt 100' 25.00
Water Service let 100' 30.00
1 'hereby acknowledge that I have read this opplicallon, that the Water Service ea. Addit 200' 25.00
infunnation given Is correct, that I am the owner or authorized agent of - -
the owner, tltat plans submitted are In compliance with State lawq, that Storm 3 Rain Drain let 10(Y 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given Is correct (if exempt from State registration, please M -
give reason below.) Mobile Homs Spate 25.00
Back Flow Prevention
Device or Antl-PcAudon Device 9 0C
Connected to a M- tune 9.00
Describe work new U addition Q alteration O repair Q Catch Basin 9.00
to be done residential t) non-residential O Insp. of Exist Plumbing 40.001hr
Specialty Requested Inspections 40.00rir
Existing use of Rain Drain, single family dwelling 30.00
building or property -
Residential backflow prevention ,
devices 15.00
Proposed use of -�
building or property __ ---- '(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee 12(.00 SUBTOTAL
PERMITS l3FCOME VOID IF WORK OR CONSTRUCTION 5`,: SURCHARGE
AUT11ORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF l -
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - -FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
°LAN REVIEW 25;x. OF SUBTOTAL
COMMENCED
TOTAL
Special Conditions -
Date issued -,by
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 6394171
BLIP
�(? bate Requested -AM ---PM — BLD
Location Z ✓� C' �N Suite — _ MEG
Contact Person _ -- Ph — ALM
Contractor __.__ Ph — — SWR
BUILDING _ i Tenant/Owner _ i ELC
Retaining Wall ELR
Footing A NO'I' REQUESTED FPS
Foundation
Ftg Drain FOUND DURING RESEARCH - SGN
Crawl Drain Ir NO INSPECTION(s) IN FILE
SIT
Slab -----_-- _
Post&Beam
Ext Sheath/Shear ---- ----- -
Int Sheath/Shear
Framing ----- -- ---- --------
Insulation
Drywall Nailing ---------
Firewall
Firewall
Fire Sprinkler - -- --------- - --
Fire Alarm
Susp'd Ceiling - -- --- -- - ---- ------
Roof
Misc: -— --- --- --- -- ------- --
Final _
PASS .- ART FAIL --
PLUM8I1077
Posf R earn
Under Slab -- --- - - — - — ---- - —
Top Out
Water Service -
Sanitary Sewer
Rain Drains _ ---- --- ---
� Fi
PASS PART FAIL — —
MECHANICAL
Post 8 Beam _ _ __------------- -----
Rough In
Gas Line - --- ------------------ --
Smoke Damp,:rs
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 I ] Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I ] Please call for reinspection RE ___-- ___ _ _ [ )Unable to inspect-no access
Fire Supply Line
ADA
Appiosch/Sidewalk Date Inspector.--___ Ext
Other -
Final
PASS PART FAIL_ DO NOT REMOVE this inspection record from the job site.
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUMENT
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 639-4171
Footing Rain Drain Cover/Service `IN
Foundation Water Lino Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing tiZe33 ,
Plbg.Und/Flr/Slab Plbg. Top Out Insulation Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. Bld .
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: e_. ____
Date � AM P.M, try: V d.
Address: .� 1_��
Tenant: _..__ Ste: _ MST: - _(���_
c --- _ BLIP: -------
Con/Own:_- -,L) — MEC:_
PLM: _
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
— - —� _—--
Inspector - -�%C1y `_-- - _----- Date:16 .__..
PROVED __DISAPPROVED/CALL FOR REINSP CF CO