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.._13107 SGV ASCENSION DRIVE ---
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: e-2 7-q / A.M. M. Z
MST:
Location: lD 7 S '4'1" „_ BUP:
Tenant: Suite: Bldg: _ MEC:
•r
Contractor: 1� ='lam — Phone: '157q' -�? PLM: .J�.]_;
Owner: Phone: ELC:
ELR:
--- — ---- _ ___ SIT:
BUILDING --BLDG(con'!) PLUMBING MECHANICAL — ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof Un1FUSlab Rough-In Ceiling Water Line
Slab Framing T u Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall `'tom Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved o pprovcd
FINAL FINAL FINAL FINAL FINAL
C7 Call for NA<'� O Reins do ee of equired before next inspection M t)nable to inspect
inspector _ -- Date: _ Pagr'-- _
of
i
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : P11-1197-0354
13125 SW Nall Blvd., Tigard,OR 97223 (503)639-4171 DATE: ISSUED: 08/26/97
PARCEL: 2S 104CB--01`00
SITE ADDRESS. . . : 13107 SW ASCENSION DR
SUBDIVISION. . . . : HILLSHIRE WOODS ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :031 JURISDICTION: TIG
CLASS OF WORK. . :ALT— �— YGARBAGE DISPOSALS. : 0 MOBILE:. HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . . 0
FIXTURES-------.-_-------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Install residential backflow pr^even ion device
Owner-: --------------------- FEES -------------- -
"fF.D TRECKER - . �-----.._�---•---.--_.____ type amoi_:nt by date recpt
13107 SW ASCENSION PRMT t 15. 00 JSD 08/26/97 97-298688
TIGARD OR 97223 `iPCT $ 0. 75 JSD 06/26/97 97-296688
Phone #: 579-•1211
Contras ar---•---
----------------------- .----
OWNER
Phone #: $ 15. 75 TOTAL
Reg #. . : 999999
------- REQUIRED INSPECTIONS --------
This permit is issuee subject to the regulations contained in the RF'/Backflow F+rev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will he done in accordance with
approved plans. This permit will expire if work is not started
within 198 days of issuance, or if work is suspended for more _ --- —than 108 days. ATTENTION: Ortgon law requires you to follow rules ----
adopted by the Oregon Utility Notification Center. Those rules are �-
set forth in OAA 952-8881-8818 through OAR 952-8881-8898. YOU may
obtain copies of these rule, or direct questions to Ol1NC by calling --
(583)246-1967„
Permittee Signat+ar^e •
+++ h++++ +++++++ +++++++++++++++++++++++++++++++++++++++++.+ t+++++++++a-+++++++
Call 639-4175 by 6:00 p. m. for- an inspection needed the next bi.:siness day
++++++++++++++++++++++++++++++++++++++•?+•++++++++++++++++++++•++ +++++4--1-++•)-++++++
ITY OF TIGARD Plumbing Application Rer'd By
3125 SW HALL BLVD. Commercial and Residential Date Recd
Date to P E.
IGARD, OR 97223 Date to DST
M) 639-4171 Permit s_
Print or Type Related SWR ate_
Incomplete or illegible applications will not be accepted Called = _
Name of DevewpmenvProjed FIXTURE 5.(Qin jlvldttal j
Sink 9.00
Job ACk-FLoc�► OFI/i C rII,6'T .��- ---
Address SbwtAddfeaa slate I.Avatoir 9.00
Uto 5w 4T fl%1S Tub or Tub/Shower Comb. 9.00
Bag s cityistate Zip - Shower Only 3,00
Water Closet 9.00
Nanny-
-; Drafnwastar 9.00
Owner Marling Addle" $YNe Garbage Disposal 9.00
3! 0 7 Jw ,4k'E,tlSic+i Wastwg Mad+kne 9.00
Ciwstaa Zip Floor Ore. 2' 9.00
J 9 - /Z
3" 9.00
femme 4 9.00
Occupant marirm9 Address Sute Water Hooter 9.00
Larxwry Room Tray 9.00
CliTs-into 230 Phone unnal - _ 900
"arm- Other Futures(Specify) 9.00
t, r 9.00
Contractor Ad"" Suite 9.00
9.00
Prior to issuance CdyfStato Zip Phone 9.00
applicant must __--
prvvmdr all Oregon Const.Cont Board Ur-# Exp.Date 9.00
contractors 9.00
IkA e Pkrnb"Lie.0 Exp.Date Seger-1st too' 30.00
ne
information SFAver-each addNbnal 100• 25.00
for COT COT Buswross Tax or Mauro i Exp.Oats Peter Service-1st 100' 30.00
database). _
Mame Water Service-eac n additional 200' 25.00
Architect Storm b Rain Dram-1st 1W30.00
or Maig Address Suite Storm b Rain Drain-arch sWifional 100` _ 25.00
Mob"Home Space 25.00
Engineer Caty/State Zip Phone Co rrnarmal Bads Flow Prevention Oev.ca or Anti- - 25.00
PofkAlorn Deviw _
Alteration O Reslenhal Backflow Preventon Device' 15.00'ssnbe wont New O Addition O ,!
c'
j be done: Residential 0 Non-,esmdentlal O - army Trap or Waste Not Connected to a Fixture 9.00
ddibonal desmptiorn o1 work Catrin Basun 9.00
NSTALLS NG 3 0?L/Y [E"� SyStf n Insp.of Existing PkrnwV 40.00
per/hr
Specialty Requested Inspections-- - 40.00
sting use of
30.00
idirng or property �FstiCJs E _
Rake Dram,single family dwelling 30.00
-000sed ise of Grease Traps -
idding or property - -�
QUANTITY TOTAL
re you capping. moving or replacing any fixtures? Yes 0 No❑ I.cvrra,c or near ai.gram is .w.ea s ouarorr Teak u >9 _ `r f r•� ,
H ys soe back t?form) `SUBTOTAL t
tiereby adknowleilge that I have read this application,chit the information
,en-s=Tea that I am the owner or authorized agent of the owner.and S% SURCHARGE ;
.t alarms submitt•,d are in compliance with Oregon State Laws.
PLAN REVIEW 2i'/e OF SUBTOTAL ,
gnatur Of ow Agent Onto
�
/I Reaurw oro*I}trRn my,try a
sc .r c. y - TOTAL
nact Peron me Phone I
*Minimum permit fee a$25• 5%surcharge.4x4 Residential Badtlow
Prevention Device.which is$15-5%surenarge
Uplmapp.doc 12196 (dst)
'LEAS LETE AS APPROPRIATE TO PROM:
Fixtures to bf crapped, moved or replaced Qty
Lavatory_
Tub or Tub/Shower Combination
Shower Only _
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain _ 2" �
3"
Water Heater
Laundry Room Tray
Urinal _
Other Fixtures (Specify)
:OMMENTS REGARDING ABOVE:
L: plmapp.doc 1196 (dst)
CERTIFICrITE OF
OCCUPANCY
pE-
CITY OF TIGAR�j J?1y1IT #. . . . . . . s MSTW-01P.-
COMMUNITY DEVELOPMENT DEPARTMENT DATE 15GUED: 08/21/96
1312SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171 VIANCEL: 2SI04CC-446103t
ADDRESS. . . : 13107 f,':;W ASCENSION DR
-:;UBDIVISION. . . . : HILLS'111RE .40ODS ZONING: R-7 PD
3LOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :031
,"LASS OF WORD,. :NEW
ryPE OF USE. . . sSF
OCCUPANCY GRP. -.'N+
OLCUPANCY [ 0AD30
Remerks : PATH I
TED TRCCKER
1406t SW CHEHAI,LM C11
TICAPD OR 9722,3
Phone #- 671 -162.?
Contractor:
3HELBURNE DEVELOPPIENT
712108 47)W NY).AF-.RG RD
TUALV-)TIN OR 97002-
Phone #c 692'-6383
Reg #, " - 423811
This Certificate prants occupancy of the above rel'sir-enced building or pcwticsn
thereof and conf irms that the blAildiny hl.iE been inspect ed for compl -.' ance with
t h p ::;tate of Ow,eyon Specialty Ccdes for the occup- nry, i:.nd usp uncier-
which the rp or nwed pe,'mll was issued.
BUILDING I N S P E C T 0 R BUILDING OFF CIFAJ)'-
POSJ 1N CON GoPIVUOUS PLACE
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
DRYER & SONS
5536 SE WOODSTOCK BLVD
PORTLAND OR 97206
Electrical Signature Form
Permit # . . . • : MST96-0110
Date Issued. : 44/01/96
Parcel . . . . . . : 2S104CC-HWO31
Site Address : 13107 SW ASCENSION DR
Subdivision. :
Block. . . . . . . . Lot : 11
Zoning. . . . . . . R-7 PD
Remarks :
PATH I
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
TED TRECKER DRYER & SONS
14061 SW CHEHALEM CT 5536 SE WOODSTOCK BLVD
TIGARD OR 97223 PORTLAND OR 97206
Phone # : 671-1622 Phone # :
Reg # . . : 1114
X "' i
Signature of Supervising/Electrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd.Tigard,Oregon 97223.8199 (503)839-4171
I
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CITY OF TIGARD
COMMUNITY DEVELOPMENT' DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (5031639-4171 {`'AI L L L
FIXTURC UNITE".
NO. OF BUILDINGE34 I
FCC[:
dat ,
'100. 2710 JMH 04/01/96 96-277C-4n
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Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 L�
(503) 639-4171 7
Jobsite Address: 5g:m_V_Q0_L-1 U
Office Use Only
Subdivision:jl-�( SH/kf 4)0D•0S- Lot # _31
� Contact Date _ / I _Initials
Valuation: 3 — Result
New Construction Only: (Square Footage) Planck/Rec # �r _
Permit # /w :5K Vay
House Z 7 qy Garaye. ___ ��_�_-__ Reissue of
Map & TL # t lC'`>'< -►1 31
Corner Lot? Y-' N Flag Lot? Y N Zone
Plat
Owner: 7 _ � �Cq IQ --�
__ Approvals Required
Address ���61 S (,✓ �� Nl1- L �n/1 (:f'77. ���
7 Planning Setbacks Solar(., oe '
'4 �--1 Engineering '�• _ rr. a.. 1 �fi�%'C.
Phone: ( j 3 ) fo 7 (r (C Other_ -T
�A�� (, Items Re ug ired
Contrartor: �f>l�l.�t31 ��
Address Q S(,J fly' ��/Z 6 v Subcontractors
70 0 FL — - Truss Details
Other 7 Notes J z c•-31
Phone: � 0 1� 2-- 6 197
Contractor's License # iqZS & __&_yCj�, //�iw —
(attach copy of current Oregon license)
Contact Name: --
Contact Phone: �3 I Z Zo—
Subcontractors: Architect/Engineen,
Plumbing: Address.
Mechanical. 0Z 6Oh/ CON'! r0A" -' -714,4t ASL/ O
(attach copy of current OP. Contractor's License)
Phone. 9I /Z.SS`-
JOB DES ON:
A 1 .
t Signatu Applicant Phone number
Received by: _ Date Received:
i.'4.Wldlt.v...OP
�G�C-,'Ie16AG (fa^/741'e roe. ICK 4' !FW- f ,SC)NS
LOW (JOG Ti9C9 EL CCT4fw c c SF oIta r
GAf-4I UAC - K
ROOM? J_4E 1ZV rG F A(A,)/U
Permit a% Account Description Amount AmL. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) 1 >I .� z
Mech. Permit (MECN)
Bldg: �3 3• G 5� c -�:-i _
---------
Plumb:
—Plumb:
Mech:
r
Plan Check (PLANCK)
Bldg: ,137• `Y
Plumb:
Mech:
L it_
le -010 Sewer Connection (SWUSA) / &1.1 C'o
Sewer Inspection (SWINSP) 3 �r 3
Parxs Uev Charge (PKSDC) U c/70 Residential TIF (TIF-R) � c/ _
Mass Transit TIF (TIF-MT) 12e� T c'
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT) 41
Fire Life Safety (FLS) _
Erosion Cntri Permit (ERPRMT) _ ' '
Erosion Planck)USA (ERPLAN) �V
Erosion Planck/COT (EROSN) �v
TOTALS: �..
J
CP
-110 i
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- �Uh� CSW� �o��� *7062
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 a
Footing Rain Drain Cover/Service FI �
Foundation Water Line Ceiling
P,jst/Beam Mach. Shear/Sheath Framing ec .
PIbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd.
Sai. er Gas Line Appr/Sdwlk t, _2.1136-
Other:
i .Other: t �— �r
Date: _� t A• y�,.P.M. — Entry: .IBJ
Address:
Tenant: _____— Ste:____ MST ��
BUP:
Con/Own:_ -z?U �C --� MEC:
--�=I-�L- PLM:
ELC: .
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
VV
Inspecto __� ._,- _�._._ Date. _ __ 1L�•
PPROVED DISAPPROVED/CALL FOR REINSP. CF CO
ISI