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9501 SW BROOKLYN LANE
/ CITY OF T I GA R D CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES DATES UIED: 0/30/98 0380
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 23111 BA-09900
ZONING: R-4.5
JUPISDICTION: TIG
SITE ADDRESS: 09501 SW BROOKLYN LN
SUBDIVISION: SHANNON MEADOWS
BLOCK: LOT:004
CLASS OF WORK: NEW
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: New SF - Path 1
Final Inspection Approved 3/22/99 by Warren Jackson, Building Inspectnr
Owner:
TOM MILLER
23720 SW KRUGER RD
SHERWOOD, OR 97140
Phone: 625-4558
Contractor:
TOM MILLER BUILDER, INC
23720 SW KRUGER DR
SHERWOOD, OR 97140
Phone: 625-4558
Reg #:
This Certificate grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use under which the referenced permit was
issued.
Arz
BUILDINMNSPECTOR BUILDING. FFICIAL �-
POST IN CONSPICUOUS PLACE
CITY OF TiGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171TMST
BUP
EC
Date Requested Am PM BLD LL``
Locationj1 )�_� L Suite MEC _
Contact PersonPh � ��_ PLM
`�--- �1:_L�
Contractor Ph _ SWR _
FL-PIN )- Tenant/Owner ELC
Retaining Wal! — ELR —
Footing Access-.
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: �j /� SGN
Slab �'i��_1L C �71� --
Post R Beam — SIT _
Ext Sheath/Shear Cat
Int Sheath/Shear ,^✓-i -
Framing
Insulation �^ p _ /) �
Drywall Nailing V �' �-�`� -�-k- C--T"-5
Firewall
Fire Sprinkler C
Fire Alarm
Susp'd Ceiling
Roof
4Mi
SS ART FAIL
ft-MBING
Post& Beam - _
Under Slab
I op Out - _ -
Water Service
`unitary Sewer
Rain Drains
Final
PASS PART FAIL _
MECHANICAL
Post&Beam
Rough In
Gas Line _.
Smoke Dampers
Final - -- -
PASS PART FAIL
ELECTRICAL - - - —
Sernce
Rough In —
UG/Slab _
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE -- ------ —
Backfill/Grading -- ---A—_-�
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Citch Basin
Fire Supply Line I )Please call for reinspection RE:_ _ _ [ J Unable to inspect no access
ADA
Approach/Sidewalk
ether _ Date /1/,Y ' �% — Inspector �� C. Ext���
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY' OF TIGARD BUILDING PERMIT
E
DEVELOPMENT SERVICES DATE ISSUED: 5/t1p 99 9 00170
13125 SW Hall Blva.,Tigard, OR 97223 (50311639-4171 PARCEL: 2S111BA 09900
SIl E ADDRESS: 09501 SW BROOKLYN LN
SUBDIVISION: SHANNON MEADOWS ZONING: R-4.5
BLOCK: LOT: 004 JURISDICTION: 'FIG
REISSUE: FLOOR AREAS, EXTERIOR WALL CONSTRUCTION_
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 8 ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,800.00
Remarks: Install an eight foot (8') high fence.
Owner: Contractor:
TOM/JEAN SHANKLES BRADLEY T. MILLER
9501 SW BORRKLYN WAY 12510 SW FISCHER RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone:
Reg #: LIC 124720
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
PLCK GEO 5/4/99 $19.18 99-314881 Final Inspection
PRMT DRA 5/10/99 $29.50 99-315239
5PCT DRA 5/10/99 $1.48 99-315239 ORIGINAL
CDRS DRA 5/10/99 $20.00 99-315239
Total $70.16
1 his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accr rdance with approved plans.
T his permit will expire if work is not started within 180 days of issuance. or if work is suspended for more
than 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Pea"itee I
Issued By: ��
Call 639-4175 by 7 p.m. for an inspection the next business day
i
+� CITY OF TIGARD Residential Building Permit Application Plan Check, '{ Le`)
13125 SW HALL BLVD. Additions or Alterations Recd By
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date Recd_
Date to P E.
V 503-639-4171 Date to D
F 503-684-7297 Permit#
Print or Type Called--- --
Incomplete or illegible applications will not be accepted
Name M Project — Name - �}
Job ,, f �'Tfritl ar7kl�_ --
Address S'a Address - Architect Mailing Address
— r City/State Zip _Phone
age
N
[� 1 n 't Je o n J aU1,6 -.___ — Name �.
Owner '��iling Add ess
rook 1 t. ^ -t- Engineer Mailing Adcress — ----^
/State ip, � —
City/State Zip Phone
General 'N te`// nn _
Conti owtor /1 I '1 0-�; J . �_-1y 1/It Ir 0 on Describe work New O Addition O Alteration O Repair O
Marling Address to be done
Prior to permit Additional Description of Work:
t
issuance,a copy y/StateZip Ph ne hCG
')f all licenses OF lD q- �53
are required if Oregon Const Cont Board Exp Date PROJECT
expired in COl Lic# 1 d Ct VALUATION
_ database _ ---- -
Mechanical Name -' NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Indicate the restricted energy installation by the electrical
issuance,a copy City/State Zip Phone subcontractor in the followin areas
of all licenses Restricted Audio/Stereo
are required if Oregon Const Cont Board Fxp.Date Energy System __— Alarms
expired in COT Lic# Installations Vacuum Irrigation
__ System
---.database Plumbing Name (check all that Other:
Sub- apply) I
Contractor Mailing Address — —� Corner Lot YES NO Flag Lot YES NO
(check one) _ (check one) _
Has the Subdivision Plat recorded? N/A YES NO
isssuauance,a copy
r tope trait Gi liie Z;p Phony —1--^
of all licenses are Oregon Const.Cont Board Exp Date 1
required if Llc.# --- ---- --
expired in COT I hearby acknowledge that I have read this application,that the
database Plumbing Lic.# Exp Date information given is correct,that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
Oregon State laws.
Name ^� Slgrralure of Owner/Age , , D t
Electrical
Sub- Melling Address — -�� Cotapt Perso pm Phonet°39533
Contractor _
1 Nil 11 ►�
City/State Zip Phone
Prior to permit
issuance,a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const.Cont.Board Eyp.Date ---
required if Lia# rMap/'�# yob
expired in COT
database Electrical Lic # Exp Date �._Setback,,.: Zone ,/ Sola -
IA
(-- -- ` Engineering
- /�V
eE1ectricl upery sor ic # Exp.Date Engin erin Approval PlanningApproval: T!�
L�
_
-- —
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
- q --- BUD
Date Requested �-Z"�9 7 AM PM BLD
Iocation_v �fi �� i tmD"'! , Suite MEC _
Contact Person Ph PLM
i;ontractor Ph SWR
13 ILDIN Tenant/Owner ELC —
Retaining Wall ELR _
Footing Access:
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab — —__ — �- *�'"� SIT
Post& Beam / �-
Ext Sheath/Shear
Int Sheath/Shear —
Framing ----------------- - --- ---
Insulation
Drywall Nailing -------------.---- ------- --- -- - -- -
Firewall
Fire Sprinkler
Fire Alarm ---_.______�-----___--------
Susp'd Ceiling
Roof
Misc: - -- - - - -------- -- -
Fi-._
eP-A-SF-� PART FAIL — --- --
PLUMBING
Post&Beam -
Under Slab
T op Out — —
Water Service I _
Sanitary Sewer
Rain Drains
Final -_---- --- - -------
PA SS PART FAIT_
MECHANICAL
Post& Beam - -- -- - ---
Rough In
Gas Line ----- - - —
Smoke Dampers
Final - - - --- --
PASS PART rA!L
ELECTRICAL - --
Service
Rough In l ._- -----
UG/Slab _
Low Voltage —
Fire Alarm
Final
PASS "ART FAIL
SITE _
Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 1312.5 SW Hall Blvd
CatSupply
Basin
F at Supply Line [ ]Please call for reinspection RE: [ ]Unable to Inspect-no access
lieADA
pproach/Sidewalk
cher
Dote _ Z _ Inspector 1 1,'r",tom Ext
f inal
PARS PART —FAIL 00 NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD MASTER F'ERMTT
DEVELOPMENT SERVICES FRMTT #. . . . . . . : MST98-0_390
13125 SW Hall Blvd., Tigard,OP 97223(503)5.19-4171 DATE ISSUED: 10/30/98
PARCEL: 2S 1 1 1 BA—SHMQA4
SITE ADDRESS. . . :09501. SW BROOKLYN L.1u
SUBDIVISION. . . . :SHANNON MEADOWS ZONING: R-4. 5
BLOCK. . . . . . . . . . I-OT. . . . . . . . . . . . . :01,,A JURISDICTION: TIG
Remarks: Now SF - Path I
--------------------------•---------------------------------- BUILDING ----------- —------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS----------- BASEMENT...: 0 sf REOUIRED SETBACKS---- REOUI
CLASS OF WORK.:NEW HEIGHT........: 22 FIRST....: 1213 sf GARAGE.....: 664 sf LEFT,.........: It SMOKE IfTECTRSt Y
TYPE OF USE...-SF FLOOR LOAD.... : 40 SECOND...: 901 sf FRONT.........; 20 PARKING SPACES: 21
TYPE OF CONST.:5N DWELLINS UNITS: I FINBSMENTi 0 sf RIGHT.........; 10
OCCUPANCY GRP.:R3 BDRM: 3 PATH: 3 TOTAL------: 2114 sf VALUE..$: 160463 REAR..........: 38
-------------------------------------------------------------------- PLUF.AN6 ---------------------------—------------------------------------
5INKS......... I WATER CLOSETS.: 3 WASH]NG MACH..: I LAUNDRY TRAYS.: I RAIN DRAIN ft: 180 TRAPS.........: 0
LAVATORIES....: 4 DISHWASHERS... I FLOOR DRAINS_: 0 SEWER LINE ft: IN SF RAIN DRAINS: I CATCH BASINS., 0
TUB/SHOWERS...: 3 GARBAGE DISP.. I WATER HEATERS,: I WATER LINT f+: 100 BCKFLW P9EVNTR: I GREASE TRAPS..: 0
OTHEP FIXTURES: 0
--------------------------------------------------------------- MECHANICAL ----------—-----------------------------------------------------
FUEL TYPES----------- FURN I W 0 BOIL/CMP ( 3HP: @ VENT FANS.....: 4 CLOTHES DRYERS, I
CAS FURN I(MY, I UNIT HEATERS..: 0 HOODS.........: I OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES.... 0 GAS OUTLETS...: I
—-------------------------------------------------------- ELECTRICAL --------------------------------------------- ------------- -
—RESIDENTIAL UNIT--- ----SERVICE/FEEDER----- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS—- --ADI)'L INSPECTIONS--
1000 SF OR LESS: 1 0 LON amp..: 0 0 200 alp..; 0 W/SVC OR FDR..: 0 PUMPARRIGATION; 0 PER INSPECTION: 0
EA ADDIL 5005F.: 4 C'01 400 alp..: 0 201 400 asp..: I 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 600 amp..: 0 401 600 amp..: 0 EA ADD[. BP CIR: 0 SIGNAL/PANEL... : 0 IN PLANT......: 0
MAW HM/SVC/FDR: 0 601 1000 alp.- 0 60I+aapsI0* v; 0 MINOR LABEL 10-. 0
1000+ alp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..- SVC/FDR)-22.5 A.: ) 600 V NOMINAL: CLS AREAUSPI OCC:
-----------—----------- ELECTRICAL - RESTRICTED ENERGY -----------------------------------------------------
A. SF RESIDENTIAL---------------- B. COMMERCIAL————-------------------—--------------------—------------------—-
AUDIO I STEREO.: VAC11" SYSTEM.,: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTITGR LNDSC LT:
BURGLAR ALARM.. 0TH: BOILER.........: HVAC...........: LA NIS CAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER.. CLOCK..........: INSTRUMENTATION- MEDICAL........ : OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....- TOTAL # SYSTEMS: 0
Owner: ---------------------------------Contractor: --------- TOTAL FEES:1 5152.46
TOM MILLER TOM MILLER BUILDER, INC This permit is subject to the regulations contained r, the
23720 SW KRUGER RD 23721 SW KNIGER DR Tigard Municipal Code, State of Ore. Specialty Codes and all
51.FMD OR 97140 SHEROM OR 97140 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone #: 625-4558 Phone #: 625-4558 no+ started w.thin 180 days of issuance, or if the work is
Reg C.: 000373 suspended fur more than 180 day,,. ATTENTION: Oregon law
------._--_-----_.-------------------Y------.-------------_.-._ requires vnii to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 95201-0010 through OAR (nu may obtain copies of these rules or
direct questions to OLINC by calling (583)246-1987.
---------------------------------------------------------- REQUIRED INSPECTIONS- -----------------------------------
Erosion 844-0444 Crawl Drain/Back Electrical Rough Insulation Insp Mechanical �In?,
Footing Insp PLM/Underfloor Framing Insp Rain drain Insp Plumb Final
FoundatiLn Insp Mechanical Insp Shear Wall Insp Water Service In Pu,lding Final
Post/Bean Struct Pkumb Top Out '7 Loot Voltage Appr1SdwIk Insp
Post/Beam Meehan 41ect , c Ser Gas Line Insp Electrical Final
Issued By: Permittee SignatiAre
-
++++++++ ++ ++-+-+.4 4-A- -+-+++++++ f 4--4-+4.4..+.4-++++++++ + +-+ +4 4 4 +f 4 4 4 -4
Call 6313-4175 by 7 00 p. m. for an inspection needed the next bl.A.Sines� cfziv
CITY OF TIGARD
DEVELOPIVIMENT SERVICES
SEWER cONNEC-r10N
PERMIT
f 15L 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PERMIT #1. . . . . . . : SW R98-0223
DATE ISSUED: 10/30/58
PARCEL: 2S111BA—SHM04
SITE ADDRESS. . . :09501 SW BROOKLYN L.N
SUBDIVISION. . . . :SHANNON MEADOWS ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :004 JURISDICTION: TIG
---------------------------------------- -----------------
TENANT NAME. . . . . :TOM MILLER BUILDER
USA NO. . . . . . . . . . . FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NEW DWELL.1NG UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL TYPE. . . . ..LTPSWR IMPERV SURFACE: 0 s;f
Remarks: New SF — Path 1
Owner: _._______..._.._._.__.__—.---__..___________—_.__.___._—__._______ FEE;_
TOM MILLER type amoLint by date i-ecpt
23720 SW KRUGE'R RD F'RMT $ 2300. 00 GEO 10/30/98 98-3104-6
SHERWOOD OR 97140 I NSP $ 35. 00 GEO 10/30/98 98- 3104:16
Phone #:
Contractor: ----.-----------------_.--_----
OWNER
-----------------------------------------------------
Phone #: $ 2335. 00 TOTAL_
Reg #. . :
- ----- REQUIRED INSPECTIONS ---- ---
This Applicant agrees to comply with all the rules and regulations Sewer Insper_tion
of the Unified Sewage Agen:y. The permit expires 188 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 installer 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
9`'52-081-*18 through OAR 952-N81-MO. You may obtain copies or
these rules or direct questions o.DM y calling 158312~6-1981.
I ;si.ted by: ! A/j Permittee Signat:.:re :
+ ++++4-+4•+++++++4-+++4•+++++++4•+++++++4•+++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for .an inspection needed the next bLlsiness day
o-' F+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++•f+•f+++++++++++
CITY OF TIGARDResidential Building PermitApplication Rec'd By_
PlanCheck#L -O,�z
13125 SW HALL BLVD. New Construction Additions or Alterations ecd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Dace Date RR P e _� 1� �.
V 503-639-4171 Dateto DSb
F 503-684-7297 1 Permit
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Project M`-t-e
Name
Job I
Address Site A fires "Architect Mailing Addre�sS l {
qA s u1 OrbI U n Lv�_l' l3U S //UU
---- -"---- it /State Zip Pone
rne
��► �Le_►� _ - - _
0%vner Mallin Address
rd J CAS Kau �— --1= Mallinr —
f Engineer L4 ,t as r�,l
C+ /State Zi one y `7
General (x! — �J/�f0 (�a S.�_ $ ate�1 ��/ Phone
Name U6�e� p�t
Contractor Url'l K✓ it. , Describe work NewX Addition O Alteration O Repair O
Mallin , res to be done:
Prior to permit JJj_( lf��t/ _ Additional Description of Work
issuance,a copy Ci y/State Zip Phone ----
of all licenses W 912i are required if regon Const Cont Board Exp Date PROJECT
expired
ineCOT' Lic VALUATION $ �y �, �PS-O
#3�_- 3 T s- lel�o�i -- ---- _
Mechanical Name r NEW CONSTRUCTION ONLY:
Sub- NtfccrlT✓ ( Sq. Ft. House Sq. Ft. G rase ~!
Contractor Mailing Address ,�[[ =_ , �/�e
Prior to permit 7 is //W 0 1 2 Indicate the restricted energy installation by the electrical
issuance,a copy +ty/late Zip Phoney subcontractor_in the follow'_ n areas __
of all licenses Vt �� % - Restricted Audio/Stereo
are required it Oregon onst.Cont.Board Exp. Dale Energy {F System _Alarms
expired In COT Lic# Installations I Vacuum Irrigation
database -- stem System
Plumbing Name (check all that Other:
Sub 0Lzylal apply)____
Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO
(check one _ (check one)
0 Has the Subdivision Flat recorded? -T^N/A —YE ' NO
Prior
uan epaco Cit, ZIP)d6 Ph -
issuance,a copy (�_ �1 Solar Compliance
of all licenses are Oregon Const Cont Hoard Exp Date
required if Lic.# r / (Calculation Attached)
expired In C•OT / , I hearby acknowledge that I have read this application,that the
database Plumbing Lic # E p Date information given is correct,that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
Oreg State laws. _
N me SigP ure of O A _ e — _ Date
Electrical V N
Sub- Mailin Address nPerson arp Phone#
Contractor FOR OFFICE USE ONLY:
City/State O Zip Phone plat#: r, waprT #
Prior to permit C�/� (,�,� I'll-
S� `;I _ Jam, //� ' 5b�r c/
issuance,a copy W,1 /5 (?d ! ✓�o G �U — � 7
01
of all licenses are Oregon Const Cont BoardExp Date Setbacks, Zorw- Solar:
required if Lic,#
expired in COT y /q �!' En ineeri Approval: Plan Approval: TIF:
P l� (� " f' 9 9 P_P 7 PP
database Electrical Lic # Exp bate r
1 SFREM2 hoc(DST)Bit 1/98
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUMENT