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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON '-AND DEVELOPMENT SERVICES DIVISION
COUNTY,
155 NORTH FIRST, HILLSBORO,OR 97124
•
COUNTY, INSPECTION REQUESTS: 503/&40.3561/693-4415
OREGON XXXXXXXXX--> 64U-3470
Page 1 of 1
Date 10/24/94
Time 17 : 06
Permit 'Type Residential Electrical permit Permit # : 05059951
Permit Status APPROVED Applied 10/24/94
Situs Address 12261 SW ANTON DR T1 issued 10/24/94
Permit 'Title Sk'R - LOW VULTAG'N'/itURGLR ALARM Completed
Permit Uescr. To Expire 04/22/95
Project Title 5k'N. LOW VOLI'AGE/BURGLE ALARM Project # P0044915
Project Uescr . * EROSION
r'arcel Ntunber : 261'TI - Land Use District
Valuation U
Lec4l Uescr.
owner INSPECTION - 'TIGARD Construction O'TH
Applicant Name AUT Classification 90U
Applicant Addr . : 703 NE HANC:OC:K Occupancy
PORTLAND OR 97212 Validated by JE'
Applicant Phone : 284-3265 Inspector Area
CONTRACTOR : AUT SECURITY SYSTEMS Lic . C 26-209C 284-3265
k'ee description Units F'ee/Unit Ext fee Data
Limited Energy/Alter./Extension -- 1 - -
4U UU 4U . UU
Subtotal Electrical k'ees : 40 . 00
State Surcharge of 5% 2 . OU
Total Electrical k'ees : 42 . 00
*** k'ees Required keds Collected & Credits ***
------------------ ------------- --------------------------------
Method Check # Receipt No . Date Payment
'DEP' 10/24/94 42 . 00
TOTAL THIS DATE *rr******* 42 . 00
k'ees : 42 . 00
Adjustments : . 00 Total Credits : . 00
Total k'ees : 42 . U0 Total Payments : 42 . 00
balance Due: . 00
f410'!:.E This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction tins started,
the permit becomes null and void if construction Is interrupted for A period of 180 days. I certify that the Information pro anted by the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will he compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy is revocable until All Inspection requirements are astlsfied and
approval is given by the Building Official. I further acknowledge that a Ilan may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
APPLICANT'S SIGNATURE
epal",WASHINGTONtfLa COUNTY RESTRICTED
Depa�•�ment of land Use $ 'transportation
Ele Nt rt l Inspection Section E L E M �I CA L ENERGY
155 North First Avenue, 1!350-12 11 ��,,
Hillsboro, Oregon 87124 APPLICATION ■
N
Information: (503) 640-3470 Fax: (503) 693.4412
PL ASE PRINT
Pie se complete • • • Project too._._._ ..._. _-__ Permit No. _
1. Location of instal latl n Label Nu.�. �:a_ Date _ le;
Address ,<•� �� I J _ 1 Issued By -____ Office
City-_ C_-_4L Zip Code . 4. Type of work:
Tax Map Map No. -- RESIDENTIAL Restricted Energy Fee $40.00
Thomas Map Book: Page_ Section � 1 (for all systems)
Directions Check type of work involved:
_�1 ��.� � �_
Aulio ana Stereo Systems*
Commercial ❑ Residential , ",burglar Alann
Tenant NameTolephone Systems*
if commercial) �_ _. - ---- Garagn Door Opener'
'This permit becomes null and void If the work authorized by the Fire Alarm
permit is not commenced within 180 days from date of Issuance Hoati ig.Ventilation and Air Conditioning Systems"
of such permit or If the work authorized Is suspended or abandoned
at ally time after work is commenced for a period of 180 days. Vacuum Systems*
Electrical Permits are non-refundnhie and non-transferable. CllF�r
2. Contractor application:
COMMERCIAL Fes for each system $40.00
Electrical Contractor — (see OAR 918-260-260)
Address
Date 1 1 / Jo,':, Number Check type of work involved:
Property 6wner _ /
Contractor's License No.
Boiler Controls
Contractor's Board Reg. No. : 911(J",.. Clock Systems
Phone No.x fs" X3.2 Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: I HVAC
�, / 4 Instrumentation
�,
Print Owner's Name�!^ Phone No. Intercom end Paging System
Landscape litigation Control`
Medical
Address
Nurse Calls
tg ado — Zip Outdoor Landscape Lighting"
This potmlf Is Issued under OAR 910-310-370. The applicant agrees Protective Signaling
to make only restricted energy InstolIsHons(100 voh amps or leas) Other
under this permit and to do the following:
f. Only use electrical licensed persona to do Instillations where
required. (Certain residential end other transactions are exempl _ Number of Systems
from licensing. These have asterlsks('). All others need 11cens-
I •No licenses are r uired. Licenses are required for all other installations
2 Call all forat. nspb�;.on when all the Installations under this permlf �
are ready for Inspection.
3. Purchase separate-permits for all Installations that are not ready 5. Fees
for Inspecth^n wrren the Inspector is art to Inspect under this
permit. Enter fees x�(.(� $
4. Assume responsibility for assuming that all corrections required _
by the Inspector Pre dcne,and 5$_
54% Surcharge (05 X total above) $
3. Assume responsibility for calling for a final Inspection when all of
the corrections are completed.
The person signing this per. musf be the applicant or a person rQtB�
authorized to bind thea ca .
Signature — /J _ Space below reserved fur validation.
Authority it other than cant __,
For inspections call
6 0-3561 or 693-4415
24-hour recorder, one worklrig day In advance of need ffA
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT E:RT I F I CA rC OF
13125 SW hAW Blvd.TQmrd,Oregon 97223.8199 (503)839.4171 OCCUPANCY
Pi✓RMI T #. . . . . . . M GT94--01.x"
o39-4171 DATE: ISSUED: 09/27/94
PARCEL: I S!34CB--15'W
T{::. ADDPEGS. . . : 1;RZ61 13W ANTON DR
SUBPI VISION. . . . : ANTON PARK 11 70NING:R--7 F-10
BLOCK. . . . . . . . . . I LIA4 . . . . . . . . . . . . :079
C;i_.f1-n or' WORK. I NEW
TYPE:: Ur' USE. . . :Si'
OCCUPANCY GRP. :R3
OCCUPANCY LOAD: '�3 4
TrrJONT NAME:. . . :
<w.,,,arks I PATH I
owner : _._._....._._.._ _..._... _.__.._..__..... ._ ____..._..
r I NNAI:i_E. HOME'S
li2,735 SW GLACIER I.. ',LY GIR
TIrJr' RD OR 97223
Phone #: ��'4~4711
Contract or,r _._.........___.. ...___........ _ .__ .__... _ . .....___... ....,...
P i NNACLE HOMES
1735 SW Gl_ACIE'R LILY C:,'IRULL
T I f ARI) OR 97223
Phone 11: 524•-4711
f?tag it. . : 16177
nc::(it_1panGy of the above referenced building 0 hereby given, and cert i f e
t;h� -()mpl. irance with the !urate Of Oregon Specialty Codes for the group,
ot.+,lf:rdnc,y, And use +.endear which the referenced perm 1t was issued.
I )INU I
1l. INC.
POST IN CONE)P T :I,JC.IUS PLACE.
1NBPRG'1ION "_AlgI
ty or Tigard Building Depars went. -
13125 SN Ball Blvd. T-pard, Oregon 97223
Inspection Line (Rec-O-Phone)e 639-4175 Bueinese Phone: 639-4171
Inspect ic,ns- ----- —--------
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out G'aa Line VBNld
Ls
Poet/Beam Struct. San. Sews • Framing
Poet/Beam !loch. Pain Drain lnnulatLon -Plumb.
Plbq. Underfloor Nater Line q Gyp. Bd. `X,
Date Roqueateds / _Times AN !\�+
Address: wLr Permit 6/3 3
Builders
79iSi+1.ONING CORRECTIONS ARlI REMIREDs
i
CIT
Inspectors_ Dates /'z?_
DISAPPROvRD --- APPROVED Af1aJE0? TO ABOVE
Call For Reinsp.
AR PERMI
7-1
CITY OF TIGARD PERMIIT#. . . . . . . :TMST94--013.3
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/21/94
13121,SW 1.10 Blvd Tigard.Oregon 97223.8199 (503)839-4171
PARCEL: 1 i 134CB--1`5200
SlIE !ADDRESS. . .. . 12261 SW ANTON DR
SUBDIVISION. . . . : ANTON PARK II ZONING: R-7 PD
BLOCK. . . . . .. . . . . . LOT. . . . . . . . . . . . . :079
__ .._...__._.._---_.__._.__._._._.____._______-•____-_ BUILDINv
REISSUE:MST93-0492 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 oaf
CLASS OF WORK. :NEW BEDRMS:4 HATHS:3 GARAGE. . . . . . . . . . :400 sf
TYPE OF USE. . . :SF FLOOR AREAS---- --- REQUIRED SE:TBACKSi---_-----.__.-_-
TYPE OF CONST. :5N FIRST'. . . . : 1055 sf LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP. :R.3 SECOND. . . :9/5 5f F RUN I . :20 ft REAR. . :30 f+
SI OR 1 ES. . . . . . . :2 THIRD. . . . :0 s f ---
HE I GHT. . . . . . . . :23 ft 1 OT - __.._ :2050 'y f SMOKE:_ DETECTORS. :Y
PLOOR LOAD. . . . :40 ps f VAL.UE. . . . . $ : 101500 PARKING SPACES. . -1
Remarks : PATH I
PLUMBING
SINKS. . . . . . . . . . . 1 FLOOR DRAINS. . . . :0 BACKFLOW P'REVNTRS. . :0
LAVAEURIES.. . . . . :4 WATE_:R HLATERS. . . : 1. TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :? LOUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSE=TS. . ::3 SEWER LINE (f t ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LIN[" ( ft ) . : 100 OTHER F"1X'TURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN I't ) . :O
WASHING MALH. . . : 1 SF RAIN DRF' S. : 1
MECHANICAL _.._____. --•-----..____.______. _____ FEES
FULL TYPES- - -- ----- UN11 HTR3. type amolint by date recpt
/GAt-, / / VENTS . . . . . :0 TIF $ 100 SW 04/21/94 -
MAX INPUT:O 131U VENT FANS. . :4 BPR1 $ 436. 00 SW 04/21/94 -
F UHN ( 10111K . . :0 HOODS. . . . . . . 1 BPLC $ 30. 00 JLH 04/04/94 94-2508!58
TURN ) =100K . . : I WOODSTOVES. :0 BSPC $ 21.. 90 SW 04/21/94 •-
F LOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 SW 04/21/94
TAOIL/CMP ( 311P:0 OTHER UNITE: 1 PARK $ 50171. 00 GW 04/21 /94
GAS OUTLETS: 1 MPRT $ 45. 00 SW 04/21/94 -
UWner.: _.._....__..___..__.__.___.._.__._.___.---..___...__ .--- Mf?LC $ 11. 4:5 SW 04/21 /94 -
P'1NNACLE HOMES MSPC $ 2. 25 SW 04/21/94 -
r . '35 SW GLACIER LILY CIR PF-'RT $ 141/1. 00 'SW 04/21 /94 -
P'St'C $ 7. 00 SW 04/21/94 -
1 1 C_;ARD OR 97223
Phone #: 524-4711
Contr•actot-: --____._..---
PINNACLE HOMES
1 c 73b SW GLACIER LILY CIRCLE
TIGARD OR 97223
Phone #: 524--4711
Reg i#. . : 16177
$ 3015. 40 TOTAL
This persit is issued swoject to the regulations contained in the ------- REQUIRED INSPECTIONS
-- -- -
Tigard Municipal Code, State of (ire. Specialty Codes and all other Foot/fol.lnd Insp Fireplace Insp
applicable laws. All work Mill be done 1L accordance with approved Past/Beam Struct Gas Line Insp
plans. This persit will expire if work is not started within 180 Post/Beam Mechran Ing t_llat ion Insr,
,�ays of issuance. or if work 1s suspended for sore than 180 days. Plm/undslab Insp Gyp Board Insp
PLM.i'Jnder-floor- Rain dr-ai.n Insp
; -erm) ttee Signatl.u-e : —_` �_.__—"✓� Mechanical. Insp Water Line Insp
►'� � Plumb Tap Out Appr/Sdwlk Insp
IssI_1e12 By. �1 Framing Insp Mechanical Final
---—___._
Call far inspection - 639-4175
--- -�—`_ ----- --- - SEWER CONNECTION
CITY OF TIGARDRMIT
r'F_'. . . .
PERMIT #. . . . . . . : SWR94--01:57
COMM'.JNlT`l DEVELOPMENT DEPAR'`PI INT DATE ISSUED: 04/r1 /n4
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 PARCEL: 1 S 1.34CB 15200
SITE (ADDRESS. . . : 12261 SW ANTON DFS
SURD I V I F I ON. . . . : ANTON PARK II
ZONING: R-7 F'D
BLOCV. . . . . . . . . .
LOT_ ...__.079--_----_,____________.___..___
TENANT NAME. . . . .
USA N0. . . . . . . . . . : FIXTURE UNITS. . .
CLASS Or WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF" NO. OF HU I LD I NGS: 1
Iill,!TALL TYPE-- - - :BUSWR IMPERV SURFACE. . :sf
Remarks : PATH I
____.___._ FEES -------____-
Owner: _____._.___.____..__._..____ ______._
PINNACLE: HOMES type -+amount by date recpt
12735 SW GLACIER LILY CIR PRM•T $ 2200. 00 SW 04/21/94 •-
INSP $ 35. 00 SW 04/21/94 -
TIHARD OR 97;223
Phone #: 524-4711
(JIN1"1RACTOR NOT ON FILE
Phone # : $ 2235- 00 TOTAL
Req #. . : REOU I REL) I NSF ECT I C SNS -- _...._....__..
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days fromthe date issued. The total amount paid will he forfeited •f the
permit expires. The Agency does not guarantee the accurar.v of the -
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from ---
the distance given. If not so located, the installer shall purchase --
"Tap and Side Sewer" Permit. and •he Agency will install a lateral. — �__•...-- ---
-y 1)R,r m i t t e e Signa t u r,e
i 7s11ed By :
Call for inspection - 639•-4175
Residential Buildingermit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(50.3) 63.9-4171
,.-iobsite Address: /� �a slti 'A/ `� " "
Office Use 0 1
Subdivision: Lot #
V Planck/Rec# (,
vaivatlon6o/ So U
Permit #
Owner: eiss<,�
47
Address: Map &� TL #�/ ,S
- -
Approvals Required
Phone. - -
Planning
i
,\2'ontractor: . L 1 c� �-� ` Engineering
Address: z- r 3 C Other _ ---_
c
J�/ Items Required
Phone: 51 V
/ -7 Subcontraclors
Contractor's License #— ( �' r-L-4----
(attach xpy of current Oregon license) Truss Details_ _ --
Subcontractors: Other
/Plumbing:
AAechanical
(attach copy of current OR Contractor's License)
Architect.(Englneer:
Address: Q L`r LA
Phone:
COMMENTS: - -
Applicant Signature & Phone r'—hQr Date Receive / /
Received by: .��
d: "Vy
Permit # Account Description Amount Anit. Pd. Bal. Due
$f� Bldg. Permit (BUILD) 1,13Y,
Plumb. Permit (PLUMB) �,o
Mech. Permit (MFCH)
State Tax (TAX) _ ✓ 3�
Bldg: U
Plumb:
Mech: :;2 Z ��
Plan Check (PLANCK) i, `_ ^; ✓ � '_
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA) V Dov
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainaga Chg (SDSDC)
Residential TIF (TIF-R) / V / L' �—
Mass Transit TIF (TIF-MT) _ (I
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-0) ^
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
TOTALS: SS450, U