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DUE TO THE QUALITY OF THE _ No.36 ��,,,,,,,,��,
ORIGINAL DOCUMENT F11911
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9519 SW BROOKLYN LANE
CERTIFICATE OF OCCUPANCY
CITY OF T I G A R D
PERMIT#: MST98-00473
DEVELOPMENT SERVICES DATE ISSUED: 1/4/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S1 1 1 B 09800
ZONING: R-4.5
JURISDICTION: TIG
SITE ADDRESS: 09519 SW BROOKLYN LN ��EC n' ?y
SUBDIVISION: SHANNON MEADOWS
BLOCK: LOT:003
CLASS OF WORK: NEW
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: Path I - New single family dwelling w/attached garage.
Final Inspection Approved 5/2/99 by Ken Schnendl, Building Inspector
Owner:
TOM MILLER
23720 SW KRUGER RD
SHERWOOD, OR 97140
Phone:
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. '/
BUILDING INSPECTOR BUILDI G 7FFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour inspection Line: 639-4175 Business Line: 639-4171 MST
BUP
Date Requested y`� ) ' ��� AM PBLD
Location I J I VI !ZLI Cj y L*? Suite MEC
Contact Person '7_-� Lol_ PhPLM _
Contractor _ Ph SWR
UIL Tenant/Owner ELC
Retaining ✓Vali _ ELR
Footing -
Foundation Access:
FPS
Ftg Drain -
Crawl Drain Inspection Notes: SIGN
Slab --
Post& Beam -� - SIT
Ext Sheath/Shear
Int Sheath/Shear -------- --.
Framing
Insulation
Drywall Nailing
Firewall --------__ - —---—-
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling
Roof - --- -- -
Misc: - -- - - -- --.._.. ----- - - ------- -----
na
PART FAIL _.. -- --------- - -- - -------- -
PLUMBING -- --
I Post& Beam
Under
--- - --- -- -- - -- - -------- ---
Under.Slab � --
Top out - _---- - - - ----
Water Service
Sanitary Sewer __--
Rain Drains -
Final -- - - ----- _.
PASS PART FAIL
MECHA C
_-.---
Rough In -__----_----- -_----- —
Gas Line _
Smoke Dampers --
AS PART FAIL -
ELECTRICAL --- ------ -- __
Service
Rough In �t -- ----- ---
UG/Slab
-- ----- - _-_-._.---------._--------
Low Voltage --- -'� M- -- -----
Fire Alarm
Final -_.. --------..---_____ ------ --
PASS PART FAIL
SITE -------------- - ----------- — -
r3- 'fill/Grading --- --- - -- - -----
ry Sewer
Jrain ( I Reinspection fee of$ `required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin --
Fire Supply Line ( )Please call for reinspection RF. _ - [ )Unable to inspect- no access
ADA
Approach/Sijewalk
Other Date y� ��� y` Inspector_ Ext
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.
CITY CF TIGARD
� Mn5'rER I"T:RMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . . MST9A-0,47,
13125 SW Hal!Blvd,, Tigard,OR 97223(503)639-4171 DnTrE ISSUED: 01 /04,,"39
SITE ADDRESS. . . :09519 SW BROOKLYN LN PARCEL: c'S 1 1 113 n--09a00
SL1BD I V I S I ON. . . . :S1-IANNON MEADOWS ZON I NO: R 4.
BL.00K. . . . . . . . . .. LOT„ . . . . . . . . . . . . :00., JURISDICTION: TIG;
Remarks: Path 1 - New single family dwelling w/attached garage.
------------------------------------------------------------------ BUILDING -------------______
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACK5---- REOUIRED------
CLASS OF WOHK.:NEW HEIGHT........: 24 FIRST....: 1131 sf GARAGE.....: 608 sf LEFT.......... : 15 SMOKE DETECTRS: y
TYPE OF USE... :SF FLOOR LOAD....: 40 SECOND... : 989 sf FRONT...,..,,, ; 20 PARKING SPACES:
TYPE OF CONST, :5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT,,,,,,,,,; 7
OCCUPANCY GRP.:R_' BDRM: 3 BATH: 3 TOTAL---- 2120 sf VALUE_$: 158794 REAR.......... : 38
---- ---- - --- -------------
--------------------------- PLUMBING ----------------
SINKS......,.. : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES..,, : 0 DiSHWASHEPS... : 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/C)iOWERS,,, ; 0 GARBAGE DISP„: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS.,; 0
OTHEP. FIXTURES: 0
---
—-------------------------------------------------- MECHANICAI- -----------------------
FUEL T"PES----------- FURN ? 100P. ,, ; 0 BOIL/CMP ? 3HP: 0 VENT FANS.....: 3 CLOTHFS DRYERS: 1
GAS FURN )=100K ..: 1 UNIT HEPTERS..: 0 HOODS....,....: 0 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLE(S... 1
-----------------•------•- —------------------ ELECTRICAL
----------------- -------------------------------------------
_-RESIDENTIAL UNIT— ---SERVICE/FEEDER---- --TEMP SRVC/FEELERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- ---ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION-
EA
ADD'L 500SF.: 4 201 400 amp.,: 0 201 - 400 amp..; 0 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 ADDL BR i,IR: 0 SIGNAL- L...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 1000 amp, : 0 601+81ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp%volt.: 0 ------------------------------------- PLAN REVIEW SECTION -----------------------------
Reconnect only.: 0 )=4 RE9 UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
---------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL-------------------___ B. COMMERCIAL------------------------- -----------------------------
----------------------
AUDIO I STEREO.: 'VACUUM SYSTEM..: RUN O I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR 1_NDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER,.,,,....: HVAC,.,,.,,.,,,: LANDSCAPE/IRRIG: PROTECTIVE STGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEM CAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL N SYSTEMS: 0
Owner: ------------------------------------Contractor: --------------------------- TOTAL FEES:f 4994,22
TOM MILLER BUILDER, INC TOM MILLER BUILDER, INC This permit is subject to the regulations contained in the
23720 SW KRUGER RD 23720 SW KRUGER DP Tigard Municipal Code, State of Ore. Specialty Codes and all
SHERWOOD OR 97140 SHERWOOD OR 97140 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone M: 625-4558 Phone I!: 625-4558 not started within 180 days of rssudnce, or if the work i�
37385 suspended for more than 180 days. 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 OLINC by calling (503)246-1987.
---------------------------------------------------- ----- REQUIRE!' INSPECTIONS ------------------------------------
------------------
Erosion 844-8444 Crawl Drain/Back Electrical Rough Gas Fireplace Electrical Final
Footing Insp N.M/Underfloor Framing Insp Insulation Insp Mechanical Final
Foundation Insp Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final
Dost/Beim Struct Plumb Top Out Low Voltage Water Service In Building F al _
fust/Beam Mechan f�gctric�I i Gas Line Insp Appr/Sdwlk Insp
Issl_red Bye T— Rermittse 5ignatr-Ir _ f —
++++ ++t++ + +{ } r 1 r i 1 }.} I i {:f-++++4++.-I+++++ F++-F + +++�+-f--+-
44+4 1 1 4 ! 1
Cal I 539-4175 by 7m i'r p,, m. for- an inspection needed the next br-rsiness day
1 �/ y-P A-
CITY OF TIGARD Residential Building Permit Application Plan Check#
By
13125 SW HALL BLVD. New Construction Additions or Alterations Recd Date ec'd +N
7
Date to P.E.
TIGARD, OR 97223 Single Family Detached to P.E. !�� �V 503-639-4171 Date to DST
F 503-684-7297 /j Permit#/�!`�_ -OV-73
Print or Type �� /'r Called 1--2 /Gf.V
aU f Incomplete or illegible applications will not be accepted /F`' rA""-'
a --43aJ
Name of Project Name
Jot., SV,U") 0 oV- ttil-etkL�o v�) "��
Site Address Architect Bailing Address
Address 1 11)"1150 StJ Ge�-k)r) IT'D•
--- -- - q r I S�rOA�r, City/State ` ip Phone
Name
f-,
Gill/State
0Y?
f,v, YYl
Owner Mailing Address Name
o S LA) R rLk k.V
City/State zip Phone Engineer Mailing ddress
c rs
—General name City/Slate Zip Phone
Contractor �r1 ►`)')/ I fir _l tr h Describe work New® Addition O Alteration O Repair O
,tAailing Address to be done _ –
Prior to permit I �-)�p K.✓t4 9,0 l,- it Li Additional Description of Work:
��c7LL Li
issuance,a copy Cit /Statep Phone
of all licenses .� A)6b
are required if Oregon Const.Cont. Board Exp Date PROJECT –7
expired in COT Lic# ?p /� VALUATION $ l S J
_ database � r7J pS r ,)i) e —
_
Mechanical Name - _ NEW C014STRUCTION ONLY:
Sub- L I SP }-fes -1 O) Sq, Ft. House: a I � � Sq. Ft. Garage
Contractor Mailing Address
Prior to permit -� r H")y a l Indicate the restricted energy installation by the electrical
S � �`
issuance,a copy 9itylState Zip_ Phone / —subcontractor in the follow' areas
--_�
of all licenses LA)7,r,1 ("/r �f i1r� Y // Restricted Audio/Stereo
are required if Oregon o st.Co t.Board Exp. Date Energy — System _ _ Alarms
expired in COT Lic.# (t>o1 9 r Installations Vacuum Irrigation
database lymerlrb PlSvstem System
umbing Name � (check all that Other:
Sub- OD6 She PhAv"b;Pl apply) -
Contractor Mailing Address — Corner Lot YES NO - Flag Lot YES NO
_ (check one) I (check one) t''
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit ity/ t to Ip Pone
issuance,a copy 2 d !d rI`. Solar Compliance
of all licenses are Oregon Const.Cont.Board Exp. Date (Calculation Attached)
required if Lic# ,, —
expired in COT // n `r ���?( �;� 1 hearby acknowledge that I have riYad this application,that the
database Plumbing Lic.# Exp.Date information given is correct,that I am the owner or authorized agent
3j /a G/4 of the owner, and that plans submitted are in compliance with Oregon%tate laws. _
Name Signa e�q�O�.ner/Ag Da
Qte
Electrical IC W N Q YI� G
Sub- Maili g Address Contact Person Name Phone#
Contractor a L- l r�1 R Uf }, /) "J
OR OFFICE USE ONLY:
Citytsfate Zip Phone Plat MapfTL#:
Prior to permit �; / �^ --q
w /-� — � Gj =�
issuance, a copy 6D,- _! 14 DI —L�_.
-1 acks: Zone: Solar
of all licenses are Oregon C nst. t.Board Exp.Date
required if Lic �/�g
expired In COT _ �-�. _1 En9;geering Approval Plannir.g Approval: TIF
database Electrical Lic # Exp Date
I SFREMI DOC(DST)8/11/98
SEE 35MM
ROL-L # 22
FOR.
LARGE
DOCUMEN..T
l
CITY OF TIGARD SEWER CONNECTION
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . : SWR98-0321
DATE ISSUED: 01/04/99
PARCEL..: 2S1IIBA-09800
SITE ADDRESS. . . :09519 SW BROOKLYN LN
SUBDTVISION. . . . :SHANNON MEADOWS ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :003 JURISDICTION: TIB
TENANT NAME. . . . . :TOM MILI-ER
USA NO. . . . . . . . . . : FIXTURE UNITS. . . 0
CLASS OF WORf-'. . . :Nr--W DWELLING UNITS. . : I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: I
INSTALL TYPE. . . . :1.TPt5jWR IMPERV SURFACE: 0 s
Remarks : Sewer ronriPction for a new single family dwelling.
Owner: FEES
TOM MILLER BUILDER, INC type amount by date reept
.23720 SW KRUGER RD PRMT $ 2300. 00 GEO 01/04/99 98-311,388
SHERWOOD OR 97t4O TNS ' $ 35. 00 GEO 01/04/99 98-311888
Phone #:
Contractor:
OWNER
Phor,e #: $ 2335. 00 TOTAL
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. 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
giv@ni 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 Sower' 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-MI-0010 through OAR 952-000I-0080. You may obtain copies of
these rules or direct questions by callin (503)246-1987.
Issued b i t t e e Signature -
F++-# f.....4...........4•......4-+4•................4.......f•+++++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
...................I..............*....................4....................4++++