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MASTER PERMIT
CITY OF TIGARD
PERMIT#: MST2000-00175
DEVELOPMLNT SERVICES DATE ISSUED- 07/13/2000
13125 SW Hall Blvd.,'Tigard, OR 97213 (503) 639-4171
SITE ADDRESS: 12740 SVV CA.FIFL D CT PARCEL: 2S104DA-01700
SUBDIVISION: QUAIL HOLLOW - WFS r ZONING: R-4.5
BLOCK: LOT:003 JURISDICTION: TIG
REMARKS: Patn 1, single family detached residence.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS _ REQUIRED
CLASS OF WORK: NEW HEIGHT: 23 FIRST: 696 of BASEMENT: of LEFT: 3 SMOKE DETECTORS: Y
TYPE OF USE: SF FI JOR LOAD: 40 SECOND: 625 of GARAGE: 436 of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N Dv,ELLING UNITS: I FINBSMENT: of RIGHT: 3
VALUE: S 718,371.55
OCCUPANCY GRP: R3 BriRM: 3 BATH: 3 TOTAL: 1,623.00 of REAR: 29
PLUMBING _
SINKS, 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 2 GARBAGE DISP: I WATER HEATERS I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
_FUEL TYPES FURN<100K: I BOIL!CMP<3HP VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>000K UNIT HEATERS: HOODS- I OT'IER UNITS: 1
MAX INP. btu FLOOR FURNANCES VENTS: I WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP ERVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp 0 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 400 amp: 201 - 400 amp: I%I WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 •600 omp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 - 1000 amp: 601+amp9•1000v: MINOR LABEL:
1000+amolvolt: PLAN REVIEW SECTION
Reconnect onlV: >=4 RES UNITS: 9VCIFDR3,•:_5 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL•RESTF"CTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL -
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH BOIL ER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATArTELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS:
TOTAL FEES: $ 3,317.44
Owner: Contractor: This permit is subject to the regulations contained in the
J &S CONCRETE INC ECK CONSTRUCTION INC Tigard Municipal Code,State of OR Specialty Codes and
19600 S LELAND RD PO BOX 204 all other applicable laws. All work will be done in
OREGON CITY, OR 97045 SHERWOOD,OR 97140 accordance with appro jed plans. This permit will expire 4
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Reg N: !1r, 114755 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 INSPECI IONS
Erosion 844.8444 Underfloor Insulation Mechanical Insp Shear Wa!i Ina:p Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Plumb Top Out Low Voltage Water Line Insp Final Inspection
Foundation Insp Footing/Foundation Din Electrical Service Gas Line Insp Appr1Sdwlk Insp Building Final
Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Fireplace Electrical Final
Post/Beam Mechanica Mechanical Insp Framing Insp Insulation Insp Mechanical Final
Issued By : /�q� �---_ _--_. Permittee Signature
Call (503) 639-4175 by 7.00 p.m. for an Inspection needed the next business day
1
nCITY OF TIGARD SEWER CONNECTION PERMIT
\ DEVELOPMENT SERVICES PERMIT#: SWR2000-00139
13125 SW Hall B:vd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 0713/2000
SI"i E ADDRESS; 12740 SW CAFIELD CT
PARCEL: 2S 104DA-01700
SUBDIVISION: QUAIL HOLLOW - WEST Z.:NTNG: R-4 5
_ BLOCK: LOT: 003 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: L1 rSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new single family residence.
Owner: ---- -- --.
J & S CONCRETE INC — _
19600 S LELAND RD Type BY Date FEES Amount Receipt
OREGON CITY, OR 97045 PRMT DLH 07/13/2000 $2,300.00 0003694
Phone: 85R-9992
Total $2,300.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
This Applicant agrees to comply with all the rules and regulations of the Jnified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will 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 all directions from the distance given. If not so located, the installc, shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987
Issued by: ;�;! _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the nex, business day
x..11 1 Vf II<,7HrlU f4C:.71UFr:I11�J• ^. )1)tl(��L�Qn ,/ rieii�.nvcRii
13125 SW HALL BLVD �Reo'd Byy
�( Date Recd
TIGARD, OR 97223 (Duplex)
V 503-639-4171 n{ ( l� I Date to P.E.G OD
F 503-684-7297 ", (� -7 L- 1, ` Daatteto#T A( !�J-eg o
D-cry/75—
l-,nnt or Type / Called-/-,3 tt-
Incomplete or illegible applications, will not be accepted
Na a of Project Name / y�
Job �lT1i`
Address Site Adcles -- Architect Mailing Address
C /Slate / ZipPhone
Name TY.,. � ���.��._.�>✓�'
Owner Mailing Address / _� p -- Name
y4 42!9S'. ��L`— �� MailingAddress
City/State - Z-ip Phone Engineer
_ _ D yo s�s-- (,f6- > t' ,kip y
City/State Zip P n
General " � �/tUc�; r''{/.rte ell
Contractor C��r' Describe work NeYX Addition O Alteration O Repair O
Ma'' g Addres -- to be done _
Prior to pennft ,: Additional Description of Work: ;
issuance,a copy Clt /State Zip Phone
of all licenses -�
are required if Oregon Const.cont. Board Exp.Date PROJECT
expired ta COT uc-n �_ �� l VALUATION
_
� —�_—
Mechanical Name/ � G NEW CONSTRUCTION ONLY: 0
Sq.
Sub- f/ Ft. House: Sq.Ft. r e
Mailing Address _S 2- 1'
Contractor ng
Prior to pe milt Indicate the restricted energy installation by the electrical
subcontractor in the followin areas
Issuance,a copy City/Stato — Zip — Phone
of all licenses Restricted Audio/Stereo
are required If Oregon Const.Cont. Board Fxp Dale Energy _ S sy tr'm _ Alarms
expired In COT LIC# Installations Vacuum Irrigation
database _ System_ System
Plumbing Name (check all that Other:
Sub- — - _-- - - —
Contractor Malting Address Comer Loi YES NO Flag Lot YES NO
'� check one _ (check one
Has the Subdivision Piet recorded? N/A YES NO
Prior to permit City/State Zip Phone !'
Issuance,a copy --- —�— --—-— —of all licenses are Oregon Cons( CorkTo-ard Exp. Date
required If Lull I heart acknowledge that I have read this application,that the
expired in C07 y g PP
database Plumbing Uc.# €x Date information given is correct,that I am the owner or authorized agent
of the owner,and that plans submitted are in compliance with
Orman State laws.
Name signature of Owner f e,t Date
Electrical
Sub- Mailing Address Contact Person Name � Phone#
Contractor
City/State Zip Phone
Prior to permit
Issuance,a copy FOR OFFICE USE ONLY: _
of all licenses oro Oregon Const.Cont Board L.p.Date ---
Plat#:
required B Lic# --- MapfTL#
expired In Col
database Electrical l.ic.# Exp.Date Setbacks: Zone: Solar
_ P y. 5 P-D
Electrical Supewlsor Lic 0 Exp.Date Engin ening Approval: Planning Approval: TIF_
i\dsts\forrrs\sfadd aft doc 12/10/99
CITY OF TIGARD 24-Hor;r
BUILDING Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 ` --
BUP _
Received - Date Requested 6a 'd u AM—__ PM _ BUP
Location _ r/ til- _.Suit;_._ _ MEC
Contact Person __- pf,( ) -- -_ PLM
Contractor__ . - `-___-- Pti(.._—.—) _ SWR
BUILLIiN Tenant/Owner -_ _ - ELC -_
Fomy -
Foundation Access: -'� ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ""` SIT
Post& Beam �� !
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �,�& � � � � � � � � - --
Framing ---- -- —n- - - --
oc
Insulation
Drywall Nailing
Firewall _ / _ Q -� t� �i /__. �-••� _J��
Fire Sprinkler
Fire Alarm 1 V
Susp'd Ceiling -
Roof - f riG� CA__
Other:
in
l4SS PART FAIL - - -- - --
_PL�IMBING
Post& Beam
Under Slab
Rough-In
Water Service _
Sanitary Sewer —
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final
PASS _PART FAIL -- ------ ---- ----- ----
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
_PASS PART FAIL
ELECTRICAL
Service - -
Rough-In
UG/Slab
Low Voltage
Fire Alarm -- -
Final Reinspection fee of s- re uired before next Ins
PASS PART FAIL q pection. Pay at City Hall, 13125 SW Hall Blvd.
SITE _ Please call for reinspection RE: - Unable to inspect-no access
Fire Supply Line
r `
ADA v t�
Approach/Sidewalk Date -,� � �' � Z` Inspector J - '--'-- Kxt
Other: _
Final 00 NIOI REMOVE this Inspection record from the job site.
PASS PART FAIL
1
CITY OF TIGARD RUILDING INSPECTION DIVIF 7N
MST
24--Hour Inspection Line. 39-417a Business Lige: 6, ,-4174
SUP
Date Requested /?� AM PM — BI
UP
LD
Lc cation I;2 -7q& S6" Suite MEC
Contact Person _ ^ PhPLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC -Retaining Wall Wall ELR
mooting Access: --- _-
Foundation FPS
Fig Drain SGN
Crawl Drain Drain Inspection Notes: - -- --- -- —
Slab ---- — - --- -—-- — -- - -- SITPost& Beam _---_--
Ext SheathiShear
Int Sheath/Shear - -------
Framing
Insulation
Drywall Nailing
Firewall - - - - - -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - -
Roof .._ --
Misc.
Final _.—,---_-_-
PASS PART FAIL - -- --- --
PLUMBING
Post& Beam -- - -
Under Slab
Top Out -----
Water Service
Sanitary Sewer
Rain Drains
Final - - - - -----
PASS PART FAIL
MECHANICAL
Pcst&Bearrl.�._
Rough In
Gas Line --�— -- -- --- ---- - - -- —
Smoke Dampers
Fina! - - --- - - -
_ PART FAIT_
ELEC
Rough Irr ------- - — --- -- _ -
UG/Slab
Low Voltage
ZeAlarrn' -/4ART Fi.!1 I - _ _ _ --- ----—- ----- —- --- --- --- —
Backfill/Grading ---_,� _._--_ __ --.- ----------.__— -----.-__ --
Sanitary Sewer
Strom Drain ( )Reinspection fee of$ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please call for reinspection RE:_�- [ )Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date 11�1 inspector Ext
z�•=--
Final � i
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISk ! MST
24-HOL'- Inspection Line: , --4175 Business Line: 639-4171
/ BUP
Date Requested ! J gLU
Location /),e,1.AJ , Suite _
----------- MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner F.LC
Retaining WallEI.R
— --T..._-------
Footing .�. _—_ --- ------ .
Foundation ACC2SS:
FPS
Ftg Drain --- ._ -----
Crawl Drain Inspection Notes: SGN
Slab
Post&Beam - ---- SIT ------------ - _
Ext Sheath/Shear
Int..heath/Shear
Framing
Insulation ---
Drywall Nailing
Firewall - -- -- ---- -- ---
Fire Sprinkler —
l=ire Alarm -- - -
Susp'd Ceiling
Roof - -
Misc:
Final
PASS PART FAIT.
LU — –
ost& Beam
Under Slab
Top Out --
Water Service
Sanitary Sewer --- — --
Rain Drains
SS' PART FAIL _
CHANICAL
Post R t3eam
Rough In
Gas Line
Smoke Dampers
Final --
PASS PART FAIL
ELECTRICAL —
Sirvice
Ro igh In
UG/Slab _
Low Voltage
Fire Alarm
Final —
PASS PART FAIL
SITE —
Backfill/Grading
Sanitary sewer
Storm Drain ( ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reinspection RE:
Fire Supply Line ( ] P _ ( )Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date Inspector Ext
Final -/
PASS_PART FAIL D -N*'041
REMIOVE thin inspection record from the job site.
. j
"ll
r- lrcr-rical Innov. , Inc. 503-1332- 6564 43. 3
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IP DRTANT PERMIT NOTICE �,
ELECTRICAL INNOVATIONS O�yF.ojy*E.
22300 S LEWELLEN RD
BEAVERCREEK, OR 97004.8733
Electrical Signature Form
Permit #. MST2000-00175
Date Issued: 01113/2000
Parcel: 2S104DA-01700
Site: Address: 12740 SW CAFIFL.D CT
Subdivision: QUAIL HOLLOW -WEST
Block: Lot: 003
Jujisdiction: TIG
Loninq: R-4.5
family detached residence.
Remarks: Path 1, single
Your company has been indicated as the electrical contractor for the permit indicated above In order for the
clectricai permit to be valid, the signature of the ,upervising electric an is required. Please have the
appropriate individual from your company sign below and return this Electrical Siqnature Form prior to the
Ftaf, the work to the address above AITN: Building Dept.
No electrical inspections will be authorized until this compieted forth is received
OWNFR ELECTRICAL CON I-RACTOR:
J & S CONCRETE INC ELECTRICAL INNOVATIONS
19600 S LELAND RD 22300 S LEWELLEN RD
OREGON CITY, OR 97046 BIEAVERCREEK, OR 97001-8733
Phono # 656-4992 Phone #:
Req #: FU 26-699c:
LIG 000643,!17
SUP 3621S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature uperrvising Electrician!
1u have any questions, please call (503) 639-4171, ext. # 310
I
CITY OF TIGARD
13125 S.W. HALL. BLVD.
TIGARD, OR 97223 `;D
IMPORTANT PERMIT NOTICE JUL 2 4 2000
WOLCOTT PLUMBING CONT. INC IL's
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signatui a Form
Permit #: MST2000-00175
Date Issued: 07/1312000
Parcel: 2S104DA-01700
Site Address: 12740 SW CAFIELD CT
Subdivision: QUAIL HOLLOW - WEST
Block: E.ot: 003
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Path 1, single family detached residence.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN Building Dept
No plumbing inspections will be authorized until this completed form is received
OWNER; PLUMBING CONTRACTOR:
J & S CONCRETE INC WOLCOTT PLUMBING CONT. INC
19600 S LELAND RD PO BOX 2007
OREGON CITY, OR 97045 GRESHAM, OR 97030
Phone #: 656-4992 Phone #: 667-1781
Reg #: I it 00023847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X -- -
Sighfure of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. 4 310