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12369 0 ANN M ,�.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW r Blvd. Tigud, )rsgov 97223.8199 (503)839-4171 MASTER F'ER11I T
FERMI T #. . . . . . . . MST1)4.. jo_:,;
639-4171 DATE' ISSUED: 10/06/94
P"ORCEL: 2S110l2AB- 0H012:,
SITF A1)1)RF iG. . . : 12269 SW F=MES L '
SU':4D I V I S I ON. . . . : ARL I t+uTON RIDGE. ZONING: R-:3, Fj
BLOCK. . . . . . . . . . : L-01.. . . . . . . . . . . . . :17112
RE:1 SSUE:: DWE L.L I N!G UNITS: I BASEME=NT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS44 BATHS-.3 GARAGE. . . . . . . . . . :616 sf
TYP'L (]F USE.. . . SF F'-LOOK ARE=AS --- RLQUIREU
TYPE: OF CONST. :5N F-IRST. . . . : 1482 sf• LEFT. . : 13 ft RIGHT. : 12 ft
OCCUPANCY GRP,. :R SECOND. . . : J.2'02 ,f' FRONT., :20 ft PE-AR. . :411 1`t
91 L;RIES. . . . . . . :2 FINBSMENT:O S REG).UIREI:i-
HE:I GH T. . . . . . . . :33 f t 10 TA L -__ ....._.-.L'&84 s f SMOKE= DETECTORS. :Y
FLOOR LOAD. . . . :40 ps f VALUE. . . . . $ : 1 t33`r69 F'ARK I NIG SF'ACES. . : 1
Rematrks a PATH 1
PLUMBING
Li INKS. . . . . . . . . . : 1 FLUOR DRAINS. . . . :0 BACKF l_OW F'REVNTRS. . : 1
LAVATORIES. . . . . :5 WATER HEATERS. . . ' I TRAPS. . . . . . . . . . . . . . :0
1 UB/)HOWERS. . . . :3 LAUNDRY T RAYS. . . : 1 CATCH FAA S INS. . . . . . . :171
WFI f LR CLOSLI S. . :3 SLWER L I NL (ft ) . :0 GREASE TRAPS. . . . . . . :LA
DiSHWASHE K3. . ., . ' I WATER LINE ( ft ) . : 100 OTHER FlX CURES. . . . . :0
G(ARBAUE DISE='. . . : 1 RAIN DRAIN (ft ) . :0
WASH I NCS MACI 4. . . . 1 SF RO I N DRAINS. . : 1
MECHANICAL _____ ___._. _._.___. _. _......__ _.__.... .-- ---..--_-.--- FEES
F1JE.L TYPES-- ---- UNIT 11TRS. . :0 type amount by date rer-pt
/GAS/ / / VENTS . . . . . :0 TIF $ 1550. 00 JF 10/06/94 -
MAX INw'UT :O D1U VENT FANS. . :4 LAPII'iT b 64:3. 00 JF 10/06/94 -
F URN t 100K . . :0 HOODS. . . . . . : 1 1-F'LC $ 41-7. 95 JF 09/ 14/94 94-
FURN ) -10011, . . : 1 WOODSTOVE:S. :0 135F'C $ 32. 15 JF 10/06/94 -
FLUOR PORN. . . . :171 CLO DRYERS. : 1 SSDC $ 280. 00 JF 10/06/94 -
BOJII_/0111' ( 3HE':0 OTHER UNJTS: 1 F ARK $ '5.00. 00 JF 10/06/94 -
GAS OUTLETS: 1 MF'RT $ 4:5. 00 .1F 10/06/94
Owner,. _____..._.._....._----------- -_ ._ ......._MPC_f F 11. 5 .JF 10/06/94 _
LIFESTYLE HOME.3 M5PC $ 2:. 25 JF 10/06/94 -
115V,00 SW BLi..ESTONE CT" '313TH $ 2_`5. 00 JF 10/06/94 -
P5PC $ 11. 25 JF 10/06/94 -
BEAVERTON OR 97007 CROS $ 64. 00 JF 1.0/06/94 -
E-'hone #: 5`4-•5252 E.RPC $ 20. 00 JF 10/06/94
La"t?,actor• : _____.---._._.______.._.__...--._-.-...- - -- - _.__ERp,r $ 2,0. 80 JF 1V_1/06/'34
LIFESTYLE HOMES
1.5000 SW PLUEt3TONF CY
BEAVERTON OR 97007
F-'hone #: 5i:?/4 -525c'.
Reg #. . : 77851
3 ,382.3. 45 TOTAL
This peroit is issued subject to the regulations contained in the - - - REG)UIRED INSPECTIONS
Tigard Municipal Code, State o, Pre. Specialty Codes and all other Foot/fol.tnd Insp fireplace Insp
app., cable laws. All work will be done to accordance with approved Fast /Beam Str•i.tct Gas Line Insp
i Fiars. This oerut will expi-e if wcrk is not started within 198 Post/Seam Meehan Ins,.ilation Insp
days of issuance, or if work is suspended for tore than IPO days. I='lm: l.tnci- (ab Insp Ciyp Board Insp
VILM/Underfloor Rain drain Insp
F r-rmt. Ztee t ignatLtre : 1_ - Mechanir.al Insp Water Li.ne Insp
E'lLtmb -rap 01.tt Appr/5dwl1i Insp
Framing Insp Mechanical. Final
Lall for inspection - 775
SEWER CONNECTION
CITY OF TIGARD r-1 E R M IT
COMMUNITY DEVELOPMENT DF:PftRTMENT PERMIT #. . . , . . . : SWR94-1213,77
13125 SW Hall Blvd,Tigard,Oregon 97223.8190 (50?)F'49.4171 DATE ISSUED: 1 0/06./94
PARCEL: 25110BD--AR012
S I TE ADDRESE. 12369 SW PMES LN
SUBDIVISION. . . . : ARLINGTON RIDGE ZONING: R--3. 5
LOT. . . . . . . . . . . . . 012
TENANT NAME=_. . . . . :
USA NO. . . . . . . . . . a FIXTURE UNITS.
CLASS Or WORK. . . sNEW DWELLING UNITS— : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL- iYPE. . . . :B I J.'314.Q IMPERV SURFACE. . : s f
Remarks : PATH I
Own e-- FEES
LIFESTYLE HOMES type amount by date reept
15000 CSW BLULSTONE CT PRMT $ 2200. 010 JF 10/06/94 -
I NSP $ - 00 JF 10/06/94 -
BEAVERTON UP 911007
Phone #: 524-525P
Cont r'.;Ct or: .I.------.-.-----.---
CONTRACTOR NOT ON FILE
2`35. 00 T 0 T A I
Reg #. . :
RE:OUIRED JNSPEC71ONS
Thio Applicant agrees to comply with all the rules and regulations Sewer Insper-tion
of the Urified Sewage Agency. The permit empii-es 180 days from
the dat? issued, rhe total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer :aterals. It 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
a "Tap and Side Sewv` Permit and the Agency will install a lateral.
Perm it t e Si gnat ure pt'4g:�c
d S y
CA11 for inspection 639--4175
C1 I i ,
Residential BualdinQ Permit Applicaticri_
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: .
I /. - y
Subdivision: rl t i �i(� Lot#_f,�,— Office Use Onl !-
Valuation: Planck/Rec # j ` 3 Z
Permit # U 3 7�
Corner Lot? Y N�
Reissue of
Flag Lot? Y
Map & TL# -�� _ ;_ �_ _.4
OwnAr: Approvals Required
Address lCn .4t.J /.�I b�( S�t�,^e�. Planning%i�
UUP�✓ LJe 2 7t�7 -- Engineering
Phone: ��`� � S2. Other
Contractor: ��a�91v1 Items Regvired
Address: _ _ — Subcontractors
- ---- Truss Details
o
Phone: _• Other
Contractor's License #17-T
(attach copy of current Oregon license)
Contact Name & Phone: n
Subcontractors: i � �. �\ Architect/Engineer: ( �
Plumbing: Ti Address: /' V) /V 1,S�it°Yv CT
Mechanical: _TI}tiz&,2 m
(attach copy of current OR Contr fors Licens
Phone:
JOB DESCRIPTION ��1 ' r � 5;.,Yj/4 K14—
A (',cant Sign ature & Phonc number
PP 9
Received by: Date Received:
N 1WORMCOMOE"ESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
rn�f9l-C,'37i Blda. Permit (BUILD) ll^ 3 .6v , y3. �
Plumb Permit (PLUMB) .2 5.GO i ,2,, Sr,
Mech. Permit (MECH)
State rax (TAX)
Bldg: 3.2
i
Plumb:
Nlech: ' >
Plan Check (PLANCK) gag, Lw % 7s
Bldg:
Plumb:
Mech-.
jSwlt. L-o 3-?2 Sewer Connection (SWUSA) c c1 vu
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) _ -SGU / ,5
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) 3V 3o
Mass Transit TIF (TIF-MT) 12,0
Commercial TIF (TIF-C)
Industrial TIF (TIF-I)
Institutional TIF ,TIF-IS)
Office TIF (TIF-O) _
Water Quality/ (V'QUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) / Ll 'J-7
Erosion Planck/COT (EROSN) _ �* �' / IS-,
TOTALS: ��� �� � �C' ,5_U i
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON RAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY. PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
A &77-
WASHINGTON COUNTY ELECTRICAL PERMIT
Department v'r Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, Il350-12 APPLICATION
Hillsboro, Oregon 97124
Information: (503) 640•-3470 Fax: (503) 693-4412
Permit � f ��
PLEASE PRINT. Number � �� J�`' Date _ / -L�'
PleaA complete all sections, 1 through 5. 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Locati n fins allatt n -- -- -
Address S L Service included: Items Cost(ea.) Sum
Building A. Residential-per unit hC
City / ov — Suite No.
1000 sq.fl.or less $110 00 4
Tenant Nage Each additional 500 sq.it -i
(if commercial) or portion thereof $25.00
Limited Energy $25.00 -- ____ 1
Map No.. —_Tax Lot -_-________._____ _ Each Manurd Home or Modular
— _ —
Thomas Map Book: Page:—^.__ Section:__--_--_ Dwelling Service or Feeder $68.00
Directions_ —.__.__ _ _._ - B. Services or Feeders
-- ------ --- Installation,alterations or relocation
�t 200 amps or loss $60.00 — 2
Commercial ❑ Residential C.`7 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 —__ 2
r 601 amps to 1000 snips --- $180.00 -- — 2
ala. Contractor i allati, , n y: Over 1000 amps or volts $340.00 2
Electrical C ntr for_ 1C Reconnect only $5000 _ 2
Address �$ _ l
City_ to _ ZIP____.___ C. Temporary Services or Feeders
DateT Job NuJnber _ Installation,alteration or relocation
Property Owner- 4 /-� - _ 200 amps or less $50.00 .__ —. 2
Contractor's License No. G 201 amps to 400 amps _^ $7500 2
Contractor's Burd Re No., - -- 401 amps to 600 amps _ $10000 _.__— 2
Reg. — — -- Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n D. Branch Circuits
License No._t* 25: Phone No. _ Now,alto(ation or extension per panel
a) The toe for branch circuits with
2b. For owner installations: purchase of service or feeder lee.
Each branch circuit $5.00
Pant caner s Name done No. b) The fce for branch circuits without
purchase of service or feeder fee.
mess — — — - — First branch circuit $35.00 2
Each add'nl branch circuit $5.00 2
iry �`t_nle- —Z P -- - E. Miscellaneous (Service or Feeder riot included)
Each pump or irrigation circle _ $40.00
The, installation is being made on property 1 own Each sign or outline lighting --- $40 00
which is not intended for sale, lease or rent. signal circuit(s)or a limited
energy panel,alteration
Owner's Signatureor extension $40.00
F. Each additional inspection over the allowable
----- -- in any of the above
3. Plan Review section (if required) Per inspection — $35.00Per hour $55.00
Please cheek appropriate hem and enter fee In section 5B. In Plant $5500
_4 or more residential units in one structure
--Service and feeder, 800 amps or more S• Fees
_-System over 600 volts nominal A. Enter total of above fees $
__Classified area or structure containing special 541. Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ --------
above apply. Not required for temporary construction Subtotal $
services. ❑ Trust Account $
------------- Balance Due $
Far inspect,ons call Thin permit become,null and vold H the work authorized by the permll Is not common—d
640-3561 of 693-4415 whin 180 days from dale of Issuance of such permit or M the work ultborized is
suspended or abandoned,i any time atter work is eommencsd for a period of lao days.
24-hour recorder, one working day in advance of need ElediiuiPermits act non-folundabieslid non transferable.
8,94
(d LS/ ✓,,�yy
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Perm t. 0 ;-: - - - - . ...- s._
74i.y.1ied 00/26/94 it>s'ut,d t:114 9Expi
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Iw,pectian Line (Rec-U Phone): 639-4115 Business Phone: 639-4171
Inspection:___-__
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top OL Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line Idg.
Plbg, Underfloor Rain Drain Framing -Plumb.-7/t
Alarm Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:— 2e- Ct Time: AM PM
Address: t x
Builder: q� - U 16 4411 Permit q:
THE FOLLOWING CORRECTIONS ARE REQUIRED: "
fA
Inspector: �-� — -`-' -- �'�� Date: 2,
2
APPROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE
\� `Call For Reinsp.