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11765 SW Koski Avenue
MASTER
CITY OF TIGARD
PERMIT#: MST2002-00485
DEVELOPMENT SERVICES DATE ,ssuED: 1/10/031
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 11765 SW KOSKI AVE PARCEL: 1S135CD-12600
SUBDIVISIOW I,AI..AMOIIKA ESTATES ZONING: R-12
BLOCK: LOT: III3 JURISDICTION: TIG
REMARKS: Construct nl;w SF detached residence.
BUILDING _
FLOOR AREA 3 REQUIRED SEI BACKS REOUIREn
REISSUE: :TORIES. 2 ._
CLASS Or W IRK: NEV. HEIGHT. 23 FIRST 559 of BA"EMENT: at LEFT: SMOKE DETECTORS.
TYPE OF USE: SF FLOOR LOAD: 40 SECOND 1^,23 at GARAGE 500 of FRONT: PARKING SPACES:
TYPE OF CONST: 5N OWE' "G UNITS: 1 n4I10 of RIGAT:
VALUE 114,900.00
OCCUPANCY GRP: R3 BDRM: - BATH: 3 TOTAL: 1.�,N M REAR:
PLUMBING _
SINKS: I WAT".R CLOSETS: 3 WASHING MACH; I LAUNDRY TRAYS: RAIN DRAINTRAPS.
LAVATORIES: .1 OIFHWASHERS: I FLOOR DRAINS: SEWER LoiEB100 SF RAIN DRAINS. CATCH BASINS
-
TUBISHOWERS: GARBAGE DISP' 1 WATER HEATERS: I WATER LINES: 100 9CKFLW PREVNTH: 1 GREASE TRAPS.
OTHER FIXTURES.
MECHANICAL
FUEL TYPES TURN�100K: 1 ROIL/CMP<3HP: VENT FANS: 3 CLOTHES DRYER. 1
FURN-100K: UNIT HEATERS HOODS: OTHER UNITS:
MAA'NP: b,u FLOORFURNANCES: VENTS. WOODSTOVES: GAS OUTLETS: i
ELECTRICAL.
_ RESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRVCIFEEDERS_ BRANCH CIRCUITS _ MISCELLANEOUS _ ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp 0 200 amp: W/SVc OR FU I': PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 5005F: 3 201 400 amp 201 400 amp: tat VylO 8VCIFDR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 500 amp: 401 900 am P: EAaDDL BR CIR: SIGNAL'PANEL: IN PLANT
MANU HWSVCIFDR, 901 1000 amp: 901+ampa-1000v: MINOR 4ABEL:
100 •ampfvolt: PLAN REVIEW SEC TIO-4
Reconnat`only:
>+4 RES UNITS: SVCIFDR>•225 A.r >900 V NOMINAL CL.S AREA/SPC OCC.
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENT IAL _ B.COMMERCIAL
AI1DIO 8 STERF-O: X VACUUM SYrV EM: x AUDIO S STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: AIL BOILER: HVAC: LANOSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENFR; X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC, X DATA:TELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
TOTAL FEES: $ 6,645.23
Owner: Contractor: This permit Is subject to the regulations contained In the
STEVE ECK CONTRUCTION ECK CONSTRUC•I ION INC Tigard Municipal Code,State of OR. Specialty Codes and
PO BOX 204 PO BOX 204 all other opplicable laws. All work will be done in
SHERWOOD,OR 97140 SHERWOOD,OR 97140 accordance with approved plans. This permit will expire If
work Is not started within 180 days of issuance,or it the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone Phone: G25-I 1'15 Oregon Utility Notification Center. Those rules are set
503-625-1305 forth in OAR 952-001-0010 through 952-001-OU80. You
Reg w: LIC )14755 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INISPECTIONS
Erosion Control Insp 8, Post/beam Mechanical Plumb Top Out Exterior Sheathing Inst Water Line Insp Mechanical F,nal 1
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Service Insp Plumb Flrel
Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Lino Insp Appr/Sdwlk Insp Building final
Foundatlon Insp PLM/Underfloor Framing Insp insulation Insp Backflow Preventor
Post/Beam Structural Mechanical Insp Shear Wall Insp Rain drain Insp Electrical Final
Ist3ued By : _�--�; 4� Pcr nittee Signature -
Call (503) 639-4175 by 7:00 p.m for an inspection needed ine next business day
CITY OF TIGARD __SEWER CONNECTION PERMIT
i
DEVEI-4P'MENT SERVICE'S PERMIT#: SWR2002-00330
POW 13125 SV1 Nall Blvd., Tioar;;, uR 97223 1,503) 639-4171 DATE ISSUED: 1 10/03
SITE ADDRESS; 11765 SW `r'.,)'Kl AVE PARCEL: 1S135CD-12600
SUBDIVISION: h;1I :1%1()IIKA ESTATES ZONING: R-12
_—� BLOCK: _ LOT: oil — _.JURISDICTION: 1 It , —
TENANT NAME:
USA NO: IXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF 6111LDINGS:
INSTALL TYPE: I-TPSWR IMPERV SUR:ACE:
Remarks: Sewer connection for new SF detached dwPl'i,�i.
Owner: FEES
STEVE ECK CON r?UCI ;ON Description ---- Date� sAmouilt
PO BOX 204 p - - —
SHERWOOG, OR 97140 [SWUSAI Swr Connect 1/10/03 $2,300.00
[SWUSAI Swr Connect 1/10/03 $0.00
Phone: 503-625-1305 [SWINSPi Swr Inspect 1/10/03 $35.00
1tiWINSI1I Swr Inspect 1/10/03 $0.00
Contractor: -----
-- -- --- — Total $2,335.00
Phone:
Re_) #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Wat:;r Services. 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 lc„ated at the,measurement given, the installer shall p..,spect
3 feet in all directions from the distance given. If not so located,the instcHer shall p nchase a"Tao and Side Sewer" Perm
/l
Issued by: 1r .�; _ rJ ,l _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the i. xt business day
Building Permit Application
City of Tigard "N'
ceived: 2 - % ' Permitno.: )
Ai� Address: 13125 SW Hall I Project/appl.no.: Expire date:
City 1-ji'igord Phone: (503) 639-4171 Date issued: _ By:-V, I Receipt no.:
Fax: (503) 598-1960 Case rile no.: Payment type:
'
Land use appruvaf: 1&2 family:Simple Complex:
— _
1 c&2 family dwelling or accessory U Comr.,eivial/industrial U Multi-family New constructi(;. U Demolition
U Addition/alterttiotL/replaceinent U Tenaa,improvement U Fire sprinkler/alarm U Other:
INFORMATION.1011 SITE
Job address: 7 Bldg.no.: Suite no.:_
Lot: Block: Subdivision: a��•y ��[-J%r/� Tax map/tax lot/account no.: /_`/ _
Project name:
Description and location of work on premises/special conditions.
#-'OR SPECIAL INFOANIATIOSI,
Inin,septic capacity solirr,etc.)
Mailing address: I & 2 fancily dwelling:
City: State: ZIP: Valuation of work...�.` ..1t. ��.....•..... $
Phone: IFax: E-mail: No.of bedrooms/baths.......................•...•..... _,
Owner's represent live: Total number of floors................................. .Z
Phone: Fax: E-mail: New dwelling area(sq.ft.) ..........................
Garage/carport area(sq. ft.)......•.•....•....•.••...
Name: �+ Covered porch area(sq. ft.) .........................
Mailing address: / Deck area(sq. ft.) ........................................
City:
State. l ZIP: Other structure area(sq.ft.) !Q
Phone: Fax E-mail: Commercial/industrial/multi-family:
Valuation of work........................................ $ _
Z`�/ Existing bldg.area(sq.ft.) ..........................
Business name: �C��Q�� New bldg.area(sq.ft.) .
Address: Number of stories
_ .............................•.•........
�
City: t:q�• 71P.
Type of construction.......................••...........
Phone: 7 = ?p Faxi:Wt m_til:
CCno.: Chcupancy group(s): Existing:
8 2. _.
New:
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
IN 1111 licensed with the Oregon Construction Contractors Board under
Name: ,-SGr/9,"� �✓ 96� _ provisions of ORS 701 and may be required to be licensed in the
Addrecs• -7 jurisdiction where work is being performed.If the applicant is
.., exempt from licensing,the following reason applies:
City: _ State:
-Contact trerson. flan no.:
Fax: E-mail —'—
Nance: L'/!�'.r1c'rfContact person: Fees due upon appli- ..on ........................... $
Address:/ �ti�7�/ J /r' Date received:
t ity: �_,• Stmt ZIP:S7� '1 Amount received ......................................... $
Phone: �jl s""7J Fax: 1 E-mai:: Please refer (c fee schedule.
I hereby certify I have read and examined this appl cation and the No all Jurisdictions woept credit cards,ptwe tali juischa in for nvn Information
atta&ed c'ceckli.t.All provisions of laws and ordinances governing this O visa U Mastercard
work :;l be complied with,whether specified herein or not. Credit card num!or: .— —_1..__1-_-
Authorized signature,�LNow;��C:- Date: w R c o stwwn on t card
Print name: ,�i'i/jc, o 4 — Cadnol dRnuwe $
r,r,�«s
-Amuunt"
Notice:This permit application expires if a permit is not obtained within 180 days aft.r it has been accepted as complete. 440461+WXWOM)
One-and Two-Family Dwelling
Building Permit Application Checklist IR('crcr„ _
Associated permits:
City ofTigard Cit of Tigard a�
City g U Electrical U Plumbing U Mechanics!
Address: 13125 SW Hall Blvd,'figard,OR 97223 UOther:
Phone: (503) 639-4171
Fax: (507, 598-1960
AREIRIr"QUIRED FOR PJIAN REVIEW �U
I Land use actions completed.Sce jurisdiction criteria for concurrent
2 Zoning.Flood 1:I,nn,solar balance points,seismic soils designation,histone diti(rict,ci,
3 Vet ilication of approved platilot.
4 Fire Jistrict approval required.
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Solis report.Must carry original applicable stamp and signature on file or with application
9 Erosion control U plan U permit required.Include drainage-way protection,silt Nnce design and location of
catch-basin protection,etc.
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review canny:be completed
ifcopyright violations exist.
I 1 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property cot. , Aevations(if
there is more than a 4-h.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of•wells/septic systems;utility locations;direction indicator,lot
area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor loops,any hold-downs and reinforcing pads,connection details,vent
size and location, _
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,Plumbing fixtures,balconies and decks 30 inches above gr,.de,etc.
14 Cross section(s)and details.Show all framing-member s'zes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,rool'construction.More than one cm,s section may be required to clearly portray construction.Show
details of all wall and roof sheathing,rex Ping,roof slope ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulatiwi,etc.
15 Elevation views.Provide elevations for new constructi(in;minimum of two elevations for addir;,tns and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendunts showing foundation elevations with cross references are acceptable. _
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
— non-prescriptive path analysis provide sperilrc:tttons and calculations to engineering standards.
17 kloor!�,00f framing.Provide plans for all Ii(K)rs/rrxof assemblies,indicating member sizing,spacing,and bearing
]ovations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered
systems,see item 22,"Engineer's calculations." _
r9 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/loist carrying a non-uniform load.
20 Manufactured floor/roof truss design details,
21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances.
I 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an enginter or
architect licensed in Oregon and shall be shown to he applicable to the project under review.
23 Five(5)site plans are required for Item 1 I above. Site plans must he 8-1/2"x 1 1"ur I I"x 17".
24 Two 1,2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. _
26 No rolled,rever,cd or mirrored building plans will be accepted.
27
28
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be (n blue or black ink.
Red ink is reserved fo,•department use only. yrs(boorcoM)
Electrical Permit Application
Date received: Permit nu.:
City of Tigard Project/appl.no.: Expiredate:
City of71gard Address: 13125 SW Nall Blvd,,rit!ard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _
t
:1 &2:familyelling or accessory U Cotnntercial/industrial U Multi-family U Tenant improvement
_ New n ❑Addition/alterat::n,'r.: ' iiew U t nhrr: U Partial
Job address: fj&_ Bldg no.: Suite no.: Tax map/tax lot/account no.:
Lot: /' Block: Subdivision: _
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
1
Job no: a Fee ;'tax
Business name: ,� rte! /f Description _ Oty. (ems) Total no_tnsp
New residential-single or mind-Gorily p. _
Address: dwellingtadtlncludesattache lipurw.
City: Y Star; , ZIP: Serviceln-laded:
Phune: Fax: E-mail: 1000 sq.A.or leas 4
CCB no.://f Elec.bus.tic.no: ..f'y' Each additional 500 s ..or portion thereof
Limitedener ,residential 2
City/metro Ile.no.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder 2
Sup. -_ License no: Services or feeders-Installation,
p alteration or relocation:
tA 61 200 amps or less _ 2
Name(print): 201 am a to 400 amps 2
-- -- 401 amps to 600 amps 2
Mailing address! _ 601 amps to 1000 amps 2
City: Stale: ZIP: Over 1000 amps or volts 2
Phone: _ FF_ax I E-mail: Reconnect only I
Owner installation:The installation is being made on property I own Tempomryservices orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
201 sps or less 2
ORS 447,455,479,670,701.
201 snips to 400 amps - 2
Owner's signature: Date: 401 to 600 amps 2
Branch circuits-nr•v,alteration,
or extension per panel:
Name: _ A. Fee for branch circuits with purchase of
Address: service or feedc:fee,each branch circuit _ 2
City: State: ZIP: B. Fee for branch circuits without purchase
- --- of service or feeder fee,first branch circuit: 2
Phone: l I- E-mail: Each additional branch circuit:
Misc.(Service or feeder not Included):
❑Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2
❑Service over 320amps-rating of1r42 UHazardouslocadon Each signor ouumeIighting 2
familydwellings U Building over IO,(x)1 square feet four or Signal circuit(s)or a limited energy panel,
O System over 601 volts nominal more resides, wits in one structure alteration,or extension* _ A _2
U Building over three stories U Feeders,400 snips or more *Description: _ --
U Occupant load over 99 persons U Manufactured structures or RV pack Each additional Inspection over the aIle table In any of the above:
❑Egmss/Ilghtingplan U Other. , _�y_ Per inspection
Submit_sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service, odor
" ---- —____— Permit fee.....................
Not all lunsdicorm reel"credit carts,please call juriuhchon fax emir'-'ormaunn. Notice:This permit application f►+
Plan review(at r
❑VISA U MasterCard expires if a permit is not obtained .) $ _�
Cwdil card number. _ _� within ISO days after it has been State surcharge(836) ...$
accepted as complete. TOTAL .......................$
__ _
Name of earfirolder u shown nn ere I cud
_ S
l rdtwlder Signature Anlwnt 4WJ46I S(6+WOM)
Mechanical Permit Application
Daterectived: Permit no. y
City of Tigard Projeet/appl.no.: Expire date:
city one rd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By. ltecciptnu.:
Phone: (503) 639-4171 --
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
&2 family dwelling or accessory U Comnmcreial/indu.;trial U Multi-family U Tenant improvement
New construction U Addition/alteration/replacement U Othrr:
Job address: �cl �L� Indicate iu boxes below.Indicate the dollar
Bldg.no.: Suite nom: _ value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: -- SubdivisiotL����r,n�" "See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: J ZIP: -
Description and location of work on pr mises.
0 11111 4_111
I__ -_- 1 t
RM
ee(en.) Total
Est.date of completion/inspection: De-W i lon (Xy. Res.onl y Res-only
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air conditunit _t CFM
conditioning
-_
Air con toning(site plan required) _
F existing share insulated?U YeF U No A teration hex sting HVW.system __ _
bt er co�ors
�� tate boiler permit no.:
Business name:
9_1 _ _ HP ---Tons BTU/H
Address: Fir smo aamper-W(Juctsmo aetectors
City: - —_ Stale: ZIP: Heat pump(site plan require ) - -�-
Phone: -
fax: E-mail: nsta rep ace urnace/bumer f
Including ductwork/vent liner O Yes U No
CCP no.: nsta ,rep ac re ocate heaters-suspended,
Citi/metro Iic,no.: wall,or floor mounted _
e
Nance(please print):: m fora Lance of er that•furnace ,
e" era on:
Absorption unitsBTU/It
Name: Chillers------.--..--. -_- HP
— Cum,ressors�-_ _ _ HP _
Arens: _ �,nv ronmenta ex rut an =vet on: W
City: State:V ZIP: Appliance vent
Phone: Fax E-mail: maust -- .,
ypel7Tures. itc rc azmat
suppression system
Name: _ an with single duct(bath fans) 0 ZO
Mailing address^ f'� � � us_ t:mapartromreaunorCity: � _State: 7_I77P_ing and diet dt ou up to out ets_LPG NO �_ Oil '� �> J_fLPhone: ' lax. E-mail: neea-c aLiditional over4outletsIxti -
rxessp p ng(sc et iaucrequi� red)
Number of outlets
Name: _ - teredaapplia appliance or eyuTpment:
Address: _ Decorative fireplace _ / (O P r / �,f
City: - - _- tate ZIP: cert-type _-----
Pttone: Fax: I: mail aWoostov pe etstovc
C er
Applicant's signature:--- - Date: —
Name(print):
Nd rl jurisdictions accept cralii cords,pieaee call jaisdictioe far nae information. Permit fee.....................$
U Visa t]Mastercard expires
This permit application Minimum fee................$
expires if a permit is not obtained Plan review(at _ %) $ JW
Croat card number: -- - Expires - within 180 days after it has been
r
- State surcharge(8%)....$ Q.-
Name deIa uo no credit cud accepted as complete.
:�Jfh-3_o_
cardbokleralgmum — --Amount 4ra161Y(GiDOK'Olfi
Plumbing Permit Application
Uatc received: Permit no.:d?r f4_t
City of Tigard Sewer permit no.: Building permit no.: _—
t Address: 13125 SW Hall Blvd,Tigard,OR 97223 Pro ccda Ino.: Expire date:
Cit vof7Tgt.ru Phone: (503) 639-4171 J pp
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: Paymenttype:
TVII-L'OF PERMIT
AI &2 family dwelling or accessory O ColnmerciaUuhdustrial U Multi-family O Tenant improvement
New U Addition/alteration/replacement O Fool service U Other:
construction
Description (ltv. D'ec(c� Total
Job address:/� 7F } J_ . New I-and 2-family dNellings oro:
Bldg.no.: _ Suite no.' (Includes 10Uft.fur each u(Ilitvconnectlon)
'Tax map/tax lot/account no.: SIR(1)bath
LthU / Block: Subdivision: S R((2)bath _
--- .1
Project name: SFR(3)bath
City/county: Z1P: Each additionalbath/kitchen
Description and location of work on premises: Site.utilities:
Catch basin area drain
D wells/leachline/trench drain
Est.date of cotnpletitut/wspcction: Footin drain(no. tn.ft.)
PLUMBING CONTRXCIOR Manufactured home utilities
Business nantc_�Ql Manholes
Address: -�l/x" _ > Rain drain connector
City: Stat ZIP: 971 ` Sanitary sewer(no.lin.ft.)
Phone: Fax: E-mail Storm sewer(no,lin.ft.) ;
CCB no.: I'lumb.bus.reg.no: Water service(no.lin. ft.)
Fixture or item:
Citv/metro lie.no.: Absorption valve
Contractor's representative signature: _ Back flow preventer
Print name: Date: Backwater valve 1 _
BasinsllavatoryClothes washer
Name: Dishwasher
Address: Drinking fountainO _
City_ State: ZIPS _ E ector sump _
Phone: Fax: E-mail: Expansion tank
Fixture
/sewer ca
Floor drains/lloor sittks/ttub
Name(print):_ �� _ — (3arba�e disposal � _
Mailing address: � I Hose bibb
CStat GIP. l�
ity: __ ice maker _ _—
Phone Fax: E-mail: Int crce tor/ tease trap
Owner installation/residential maintenance only: The actual installation Printer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employer.on die property 1 own as per ORS Chapter 447. Sink(s),basin(s), ays(s)
owner's signature: Date: --
Tubs/shower/shower an
Un*nal
Name: __ Water closet
Address: _ Water heater – — — /
City: State: 'LIP Other:
Phone: Fux: E-mail: Total
C Minimum fee................S =,` ^
Na"" vl�,,,t ,ao„� p1 1A- pleue eau don rut mora infucnuliun. Notice:this permit application Plan review(at ` ) $ -
O Visa G`MasterCard expires if a permit is not obtained State surcharge(8%)....
Credit card nur.lta: resp within 180 days after it has been TOTAL $
accepted as complete. .......................
Name or rvZoldet u blown on=41 card $
C"oldet signature Amount 4MY/1i1t3(W7atCOM)
L -- -- 52.00' — — — —
I LOT 13 1
LIN� 1 G2 ire I
6,-. —E.., Tinf& — - — - 5' .
IN
I I PROPOSED GARAGE 1 ,O
RESIDENCE
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SUNTEL HOME DESIGN,INC IS NOT
I I BLE FOR THE ACCURF!Y OF THE LU3AL Xf(WTK_`P �> a
TOPOGRAPHY iNFORMATION 11 IS
THE SOLE RESPONSIBILITY OF THE TO BF ATTR-HED �-
BUILDER TO VERIF!ALI. SITE 6S.«
CONDITIONS,INCLUDING ANY FILL . ._____
PI ACED ON THE SITE,AND INFORM
OWNERS OF ANY POTENTIAL FIELD
MODIFICATIONS NtVr. St rte+
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
NORTH STAR PLUMBING
'1445 SE OREGON STREET
SHERWOOD, OR 97140
Plumbing Sig►'dture Form
Permit #: MST2002-00485
Date Issued: 1110103
Parcel: i S135CD-12600
Site Address: 11765 SW KOSKI AVE
Subdivision: KALAMOIIKA ESTATES
Block. Lot. 013
Jurisdiction: TIG
Zoning: R-12
Remarks: Construct new SF 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 Division.
No plumbing inspections will be authorized until thi-- completed form is received
OWNLR: PLUMBING CONTRACTOR
STEVE ECK CONTRUCTION NORTH STAR PLUMBING
PO BOX 204 1445 SE OREGON STREET
SHERWOOD, OR 97140 SHERWOOD, OR 97140
Phone #: 503-625. 13n5 Phone #: 625-2679
Reg #: LIC 00090697
MET 00002694
PLM 34.255PB
AN INK SIGNATURE IS REQUIR ON "THIS FORM
Signa ure of Authorized Plumber
If you have any questions, please Cali (503) 639-4171, ext. # 310
r
CITY OF TIGARD
13125 S.W. HALL BLVD
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE:
WILLIAM BUTTERF=IELD CONTRACTING
PO BOX 305
13120 SW MORGAN RD
SHERWOOD, OR 97140
Flectrical Signature Form
Permit #: MST2002-00485
Date Issued: 1110103
Parcel: 1 S135CD-12600
Site Address: 11765 SW KOSKI AVE
Subdivision: KALAMOIIKA ESTATES
Block: I-ot: 013
Jurisdiction: TIG
Zoning: R-12
Remark- Cnnstruct new SF detached residence.
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
:Ippropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
I OWNER: ELECTRICAL_ CONTRACTOR:
STEVE_ ECK CONTRUCTION WILLIAM BUTTERFIELD CONTRACTIN(
PO BOX 204 PO BOX 305
SHERWOOD, OR 97140 13120 SW MORGAN RD
SHERWOOD, OR 97140
Phone 11: 503-625-1305 Phone #: 503-625-677:!
Req #: LIC I I ;{a
ELE s- ,
st ip 0"',
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X t - - —
Signature of Supervising tectrician
If you have any questions, please call (503) 639-4171, ext. 4 310
/ CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERA !CES PERMIT#: PLM2003-00259
CATE ISSUED: 6/10/03
13125 SW Hall Blvd., Tigard, OR 9/223 (503) 639-071
PARCEL: 1 S135C'r)-126Q0
SITE ADDRESS: 11765 SW KOSKI AVE
SUBDIVISION: KAL.AMOIIKA ESTATES ZONING: R-12
BLOCK: LOT: 013 JURISDICTION_TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MAI—"H: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R:3 FLOOR DRAINS: TRAPS:
STORES: WATER HEA'rERS: CATCH BASINS:
_
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN nRAIN: ft
Remarks- Install irricjition backflow preventer.
FEES
Owner: Description Date Amount
STEVE ECK CONTRUCTION I I'I ('\113 I I'rrn it I cc 6/10/03 $36.25
PO BOX 204
SHERWOOD, OR 97140 6/1011)3 $7_.90_
Total $39.15
Phone : 503-625-!305
Contractor:
GROVER'S LANDSCAPE SERVICES
26485 S. MERIDIAN RD.
AURORA, OR 97002 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone : 503-67}1-171)0 Final Inspection
Reg #t: 1 I( 11807
This permit is issued sL,hiPct to the ret„ dations contained in th Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTUMON: Oregon law requires you to follow rules adopted by the Oregon
By: �/ h' , ! / -J(r �� r Permiflee Signature: el
;sued B --— g —�
Call '603) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
1
BUIRlIng r, wxtures FOR OFFICE USE ONtV
Plumbing Permit Application Received Plumbing
Dae/Bt ^ 0-0 Pcmtit iJ t.:f' •p3 -O �F
v/ / 3 I�
Planning Approval Sewer
City of Tigard /I Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review other
Tigard,Oregon 97223 Uat 13 : Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Date/By: Case No.:
Internet; www.ci.tigard.onus Contact J ria.: See Page 2 for
24-hour inspection Request: 503-639-4175 Name/Method: Supplemental information.
_ — TXPE OF WORK FEE*SCHEDULE(for special Information use checklist
New construction � Demolition Description t?ty. Fce(ca.) Total
— ; New I-&2-family dwellings
Additiot>/a;reration/rerlac -meat [, '�tner: y g
includes 100 ft.for each utili connection)
_ CATEGORY Or'CONSTRUCTION 2-9,20
SFR I bath
1 &2-Family dwelling Commercial/Industrial SFR(2)_bath 350.00
accessory Building—' Nfulti-Family _ SFR 3 bath 399.00
C Master Builder Other: Each additional bath/kitchen 45.00
_ JOB SITE INFORMATION and LOCAT ON Firesprinkler-sq. ft.: Pa c 2
bJob site address: 7 • dw►"t` Site Utilities
Suite#: _ , Bld ./A t.#: Catch basin/area drain 16.60
Dr ell/leach line/trench drain 16.60
Project Name: Footing drain no.linear ft.) _ Pae 2
Cross street/Diregions p job site:,., Man,ifactured home utilities 110.00
�pvir ewe-+•t C Manholes _ 16.60
l Rain drain connector 1660
Sanitary sewer(no. linear ft.) Pae 2 -
- — --- Storm sewer no. linear ft. Pae 2
Subdivision: .3 J--
----- - --- ------- Lot#: /
------- Water service(no. linear ft.) __ Pave 2
Tax ma / steel #: _ __�.. _ Fixture or Item _
RK
DESCRIPTION OF WOAbsorptionI G.60
_ ---- valve
Backflow creverccr _ Page 2
water valye---,> 16.60
—rr01WffWn1VFr 16.60
_—� — — ----- Dishwasher _ 16.60
Drinking fountain 16.60
ROPERTY OW ER TEN T Eicctors/sum 16.60
Name: G �S T� ue-/ Ex onsion tank 16.60
Address: Fixture/sewer cap 16.60
Cit/State/Zip: Floor drain/floor sink/hub 16.60
Garbs c disposal 16.60
Phone: rax: Hose bib — 16.60
APPLIC_AN'f _ _ CONTACT PERSON Ice maker 16.60
Name: — Interco tor/ tease trap 16.60 _
Medical gas-value: S Pae 2
Address: Primer 16.60
City/State/Zip: _ Roof drain commercial 16.60
Phone: sint�basin/lavatory 16.60
E-mail: �— Tub/shower/shower pan 16.60
CTO Urinal 16.60
ONTRAL
— --�— Water closet 16.60
Business Name: -1 cO e'n 44L _f��7r -r`v `r Water banter 16.60
Address: ' (r S t't? 62ir tk, r22, Othct: —
Cit /State%� L �41'L?i4� �r--r7t e Other.
Phone: o -3 i� /;1;T� F
axPI mblaa Pert��tt Fees*
Subtotal S _
CCB t.ie. l/ )Umb_LicA Minimum Pcrmit Fe.,572.50 $
Sign i Residential Backflow Minimum Few:..16.25
Sign
e: — __ nate: ` -�d—��-� Plan Review, 25%of Permit Fee $ _
State Surcharge(8%of Pvr? it Fee S
(I'Icase print naAnilrml — -- — TOTAL PERMIT FEE S
N,)tice: This pertnit application expire%if a permit I%not obtained within 11i nu, commercial buildings require 2 rete of plans with Isometric or
IRO da\s after it ha%been accepted as complete. riser diagram for Pian revlew.
*Fee ntethodniop set Irv'rri-County nuiidinf!Industry Service Iloard.
i,Usts',I'crrmt I:atms\Pln,PcnnilApp.doc 01103
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _—
BUP —_
Received ___—_. Date Requested_.__ << AM _—_ PM_—__—_. BUP
Location (o ___Kii-114, Suite —__ MEC
Contact Person ______ _.— — _._—_ -- Ph(---) _ -- PLM
Contractor—_— ___ _--_—_—_ Ph( _) SWR _
.BUILDING Tenant/Owner —_ ___ ELC
Footing -- ELC
Foundation Access:
Fig Drain ELR —_---
Crawl Drain
Slab Inspection Notes: SIT
Post R Beam
Shear Anchors --__------ —
Ext Sheath/Shear
Int Sheath/Shear
Framing -- ----- _ -— --
Insulation
Drywall Nailing --- - ----- - ---
Firewall
Fire Sprinkler
Fire Alarm
Susp Ailing -- - - - --- -- ----
Roof
Other: - --- - - - --_-------- -- -
Final
PASS PART FAIL
PLUMBING -« ------ -- ---- -- - ---- -- - ----
Post& Beam -
Under Slab - -. _ --..-_-__._----- -
Rough-In
Water Service --_- __--__-- ----_—� -.__--- --
Sanitary Sewer
Rain Drains -— -- ----- -
Catch Basin/Manhol.�
Storm Drain -----
Showe, Pan
Other:4kOK_ -
E: HART FAIL
MECHANICAL _-
Post& Beam
Rough-In -- - - -- ------ -
Gas Line
Smoke Dampers — ----------_--__..__--_.--- -__-._--
Final
PASS PART FAIL - -- ----- -- - - --------- ----- -
ELECTRICAL
S3ervice
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection rae of$ -__..._— required before next inspection. Pa at Cit Hall, 13125 SW Hall Blvd.
PASS PART FAIL [ 1 p , m - g �N y Y
SITE — [ -I Please call for reit�spection RE:-___ __—_— --- - . L�1 Unable to inspect- no accp..s
Fire Supply Line
ADA �r
Approach/Sidewalk Date Inspector -`/' ,. �_- - Ext
Other:
Final —� DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (!;03)'539-4175
INSPECTION DIVISION Busmc!ss Line: (503)639-4171 MST
BUP
received _ Date Reques)ed_—Co_--� AM_— PM ____ BLIP _
locationSuite MEC
-�Contact PersonPh( ) 11 —.. PLM
Contractor _- _-- Ph(--) SWR --_._—_--
_BUILDING Tenant/Owner _--_-__ - ELC
Fo)ting
Foundation Access: ELC -
Ftg Drain ELR
Crawl Drain --"- _--- --- -
Slab Inspection Notes: SIT
Post& Bear i -
Shear Anchors --- - - - - --
Ext Sheath/Shear
Int Sheath/Shear - -
Framing ---- --- --- ---...._
Insulation �' k
Drywall Nailing =------ ---
Firewall - -
Fire Sprinkler - -- -- - ------_—_.- - - - -
Fire Alarm
Susp'd Ceiling --- - --
Roof
Othor. - - -- ------------ --
ASLUMBING
PART FAIL
-- -
Post&Beam
Under Slab
Rough-In
W;_lerService _-_.--
Sanitary Sewer
'lain Drains --_�. _ - - —--- -- - - -
Latch Basin/Manhole
Storm Drain - ------ _ --— - — ---- -.— _
Shower Pan
Other: ----_---- - --- -- - -- ----- _—_
Final
PASS PART FAIL -_---- --- -- -- — - -- -
MECHA-NICAL
Post&Beam
Rough-In -__ ___ -__-_ __ - ------------- --
Vas Line
Sm ke Dampers - ------------- - __.__.-- -------- -- -- ---- --
fin
PART FAIL -- --- ---
CTRICAL
S arvice -- - -
Hough-In --- -- __ --------- -- -- -- - _ - -_.
UG/Slab
Low Voltage
Fire Alarm
Final E] Reinspection fee of$__._,...-._._ _- required before n3xt inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART_ FAIL
SITE L� Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line /
App
pP 7 roach/Sidewalk Date ��r C � Inspector _[ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PAnT FAIL
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CITY OF TIGARD 24-Hoer
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST ZsL
BUP __—
ReceiVEd ___________—�Date Reques ed___.____( AM—_--- PM _— BLIP
Location — 1�_1 _Z_ l�-� � Suite—_ _ _— MEC
Contact Person — _------_----- _—__-_- Ph(-.--) _-- PLM --
Contractor _____--------_�..__--- -- -_-----.—___ Ph(-_—__-) ------_-__-- —_-- SWR
BUILDING Tenant/Owner _ ELC
Footing ELC
Foundation Access:
Fig Drain ELR
Crawl Drain --
Slab Inspection Notes.- SIT
Post if, Beam --... ------- - -
Shear Anchors __.---
Fxt Sheath/Shear l
Int Sheath/Shear
Framing - - -- ----
Insule-tion
Drywa4i Nailing ---------._._.--_- --
Firewall
Fire Sprinkler - -- - -
Fire Alarm
Susa'd Ceiling
Roof
Other:
Final
PASS PART FAIL_ -
PLUI►ABING—
Post 8 Beam
Under Slab
Rough-In
Water Service -----------
Sanitary Sewer
Rain Drains - -----
Catch Basin/Manhole
Storm Drain - ---- -
Shower Pan
Other: - -.._-�-- - --- -----
ring
~PASS PART FAIL
MECHANICAL
Post& Beam
Rough-In - --- --- -- ---- -._..__--__
Gas Line
Smoke Dampers ---_-.-- — -----�- _ ____----__-- -
Final
PASS PART FAIL --- _..-- - ---- --------------- - - - - ----
ELECTRICAL
Service -� --- --- ----- - --------- - -------_- .___ ...___
Rough-In --- - -- - - - --- - -------------------._.-----
UG/Slab
Low Voltage
--- ---------
Fire Alarm
Final -, Reinspection fee of$__ _ ;equced before next inspection, Pay at City Hall, 13125 SW Hall Blvd.
PASS PART AIL
SITE -_ Please call for reinspection RE:__-- _-._ -..__ [ Unable to inspect- no access
Fire Supply Line �.
ADA Data (�? `/c _ Inspector Ext
Approach/Sidewalk -
Other
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour -2
BUILDING Inspection Line: (503)639-4175 _0 O f
INSPECTION DIVISION Business Line. (503)639-4171 BUP
MST
Received ______ ______Date Requeste PM Dt1P
Location _�_�—l�i '5.--. h74 - A' —_—__. Suite-�__----- �__._7 MEC �.---
Contact Person _-- -- _-- --._----_-_—_ Ph(.-__.—_--i —1 b_.�J1� PLM --
r.. l }' _ C�L_ `� SWR
Contractor_ -� d � r ��T�Z,.�..__ Ph _— �.� - �--' ------- -__.—..—
. -�_�-.ice �.' (
BUILDING Tenant/Owner ELC
Footing _ ELC
Foundation
Access:
Ftg Drain ELR -
Crawl Drain -- _�- ---- ---
Slab inspection Notes: SIT —
Post&Beam - ----- - . - ---- ------- -
Shear Anchors - --- --
Ext Sheath/Shear _
Int Sheath/Shear
Framing - -- - ----- ---- - -------- --._�
Insulation
Drywall Nailing —
Firewall
Fire Sprinkler - - - __ ------- -----
Fire Alarm
Susp'd Ceiling - -- -
Root - - __ — - ------- -- ---- -
Other:
Final
PASS PART FAIL
-PLU
WING
_ —
Post&Beam i—
Under Slab ---- - -- - ___-� -- ----.- -- --
Rough-In
Water Service -
Sanitary Sewer
Rain Drains ------_ -- -- -- - -
Cat,h Basin/Manhole
Storm Digin -- _ _ ----- -- --- - -- ---- _ .. -- -
Shower Pan
Other: -----
Final
PASS PART FAIL
M_ECHANIC_A_L -- - --- -- - ------ - - --- - -
Post&Beam
Hough-In -
Gas Line
Smoke Dampers ---- -- -
1 incl
Pt.SS PART FAIL ------ ----- - _-_�_-�- �_-
ELECTRICAL—_— — --- ----- __— — — --
Service
Rough-In
UG/Slab -
I ow Voltage
FirQ Alarm
�n ` Reinspection fee of$__-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
•_ 1iy�L
PART FAIL -.
SITE 1 Please call for reinspection RE:__-___. _ -- _-._._ ---_--_ -_ Unable to inspect- no arress
Fire Supply LineADA
Approach/Sidewalk Date V >�� IMspoeor Czlc� Ext
Other:
Final DO NOT REMOVE this InsQectlon record frolm the job site.
PASS PART FAIL