11785 SW KOSKI AVENUE 00
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1178.5 sW 1:oski Avenue
CITY
OF TIGARD - MASTER PERMIT
PERMIT #: MST2002-00480
DEVELOPMENT SERVICES DATE ISSUED: 1110iO3
13125 SW Hall Blvd., Tigr,rd, OR 97223 (503) 639.4171
SITE ADDRESS: 11785 SW K0!rK1 AVE FARCE,-: 1S135CD-12500
SURDIVISIC`I: KAL AMOilKA ESTATES ZONING: R-12
BLOCK: LOT: ul' JURISDICTION: TIG
REMARKS: Cons,. new P1 detached residence.
BUILDING
REISSUE: STORIES: 2 __—_ FLOOR AREAS_ _ REQUIRED SETBACKS - REUUIkED
CLASS OF WORK: NEW HEIGHT: 23 FIVST. Sy! sl BASEMENT. al LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR'.OAD: 4,i SECOND. 1,023 sf GARAGE 500 st FRONT. PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 t4FO 0 of RIGHT:
VALUC: 161b3S.00
OCCUPANCY GRP: R3 BDRM ,
` 3 BATH: 25 TOTAL, 1.620 of REAR:
PLUMBING
SINKS: 1 WAT ER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS
TUBISHOWERS: 2 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES.
MF JHANICAL _
rULL TYPES FURN-100K. I BOIUCMP<AHP: VENT FANS: 3 CLOTHES DRYER: I
FURN>-TOOK: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FUR14ANCES: VENTS- WOOrISTOVES: 1 GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE t' EDER TEMP ERVC/FEEDERS BRANCH CIRCUITS GAISCELLAN SOUS- ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp. 1 0 200 amp: W/SVC OR FOR: PUMP/IRRIGATION. PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 emp: tat WC SVCJF OR: SIGN/OU'LIN LT. PLR HOUR:
LIMITI.D ENERGY: 1 401 600 x. n- 401 000 antp: EAADOL BR CIR: SIPNAL/PANEL: IN PLANT:
MA 4'..IM/SVCIFDR: 601 1000 amo 60. amps-1000V MINOR LABEL:
1000*amp/volt PLAN REVIEW SECTION
Reconnect nnly —4 RES UNITS: SVC/FDR-225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A,SF RESIDENTIAL _ B.COMMERCIAL
AUDIO&STEREO A VACUUM SYSTEM A'JDIO&STEREO: FIRE ALARM: INTERC'OMIPAGING: OUTDOOR LNDSC LT.
BURGLAR ALARM: X OTH: ALL 160ILER: HVAC LANOSCAPEIIRRIG PROTECTIVE SIGNL,
GARAGE OPENER: ., CLL^.K: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATAITELE COMM. NURSE CALLS: TOTAL a SYSTEMS:
TOTAL FEES: $ 6,739.69
Owner: Contractor: This permit is subject to the regulations r_ontained in the
STEVE ECK CONTRUCTION ECK CONSTRUCTION IN^ Tigard Municipal Code,State of OR. Specialty Codes and
110 BOX 204 PO BOX 204 all other applicable 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 If the
work is suspended for more than 180 days ATTENTION:
Oregon taw requires yuu to follow rules adopted by the
Phone: Phone 625-1305 Oregon Utility Notification Center. Those rules are set
503-625-1305 forth in OAR 952-001-0010 thrrigh 952-001-0080. You
Rep M. I )� 1 14�, may obtain copies of thew"rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp& Post/Beam Mechacica Plumb Top Out Exterior Sheathing Inst Insulation Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Mechanical Final
Footing Insp Crawl Drain/".ckwater Electrical Rough In Fireplace Insp Water Line Insp Plumb Final
Foundation Insp PLM/Underfloor Framing Insp Gas Line Insp Water Service Insp Building Final
Post/Beam 0tructural Mechanical Insp Shear Wall Insp Sas Fireplace Appr/SdWk Insp
Issued By : ��� 4 �' �� _. Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed thy, next t;usiness day
ttttttttt�tttttt���ttttt�a �■c�
CITYOF TI GAR D SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00326
�-� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/10/03
PARCEL: 1 S135CD-12500
SITE ADDRESS; 11785 SW KOSKI AVE.
SUBDIVISION: KALAMUIIK,% FS IA I I S ZONING: h-1
BLOCK: LOT: ul' — _ JURISDICTION- l 16
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW L'WELLING UNI1S:
TYPE OF USE: SF NO, OF BUILDINGS:
INSTALL TYPE: LT",WR IMPERV SURFACE:
Rema,1-s: Sewer connection for new SF detached residence.
Owner: — - I--- ------__FEES --- -
STEVE ECK CONTRUCTION Description —Date Amount
PO BOX 204 ---- ----
SHERWOOD, OR 81140 [SWUSA]SwrConncct 1/10/03 $2,300.00
1 SWLJSA]Swr Connect 1/10/U3 $0.&,
Phone: 503-625-1305 11SWINSP)Swr Inspect 1/10/03 $35.00
1SWINSI11 SkNr Inspect 1/10/03 $000
Contrac:'or: -
--- --- ------- — Total $2,335.00
Pho ie:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clian Watot Services. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the p -mit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at th, 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" Perm
Issued by T. ' a�;�r�� �` Permittee Signature:/..1--
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
' Building Permit Application
Datereceived::j _c,a— Permit no.:, p
City of Tigard
Rojecdappl.no.: Expire date.
Address: 13125 SW Hail Hb',i, f hard,OR 97223 ;
L'ity of Tigard Date issued: By;, w— R.+ceipt no.:
Phone: (503) 639-4171 ��E�;� ��E�
Fax: (503) 598-1960 Case file no.: ------��Payment type:
Land use approval: 1&2 family:Sirnp,e f Compicx:
I &2 fatuity dwelling or accessory U06"jNf9'iWAWPNra Multi-family VNew ;onstruction U Dt,molition
iAAddition/alteration/replacement U Tenant improvement U Fire sprinkler/al U Other:
I Job address: Bldg.no.: Suite no.:
Lot: Block: Subr'.tvision: 11• Tax map/tax_lot/account no.: --
Project name: A/yo i i _--
Description and location of work on premises/special conditions: --
1 1
Name:
Mailing address: ( I & 2 family dwelling: oo,
-_
City: State: ZIP: Valuation of work........................................ $� _
Phone: Fax: Email. No.of bedrooms/baths.................................
Owner's represen five: Total number of floors.................................
�l
Phone: hax: Email: New dwelling area(sq. ft.) .......................... D
Garage/carport area(sq.ft.)......................... _ Q
Name: Covered porch area(sq.ft.) ................I........
- - - - ---- Deck area(sq.ft.) ...
....................................
Mailing address: _..—_
City:_ -State: ZIP: Other structure:area(sq.ft.)... ......................
Phone Fax: I E mail: — Commerclallindustrial/multi-family..
Valuation of work........................................ $_
Existing bldg.area(sq.ft.) .......................... —�_-
Business name: '/—� �Q �!e%' t _, New bldg.area(sq. ft.)
Address: Oka ._ Number of stories .
City: Type of construction.
/ State: Z;f ................................... ---_
Phone: p f Fax E mail: Occupancy group(s): Existing: _
CCB no.: l�� �.� - ---- - New:
City/metro 1(c.no.: Notice:All contractors and subcontractors rre required to be
hLomsed with de Oregon Construction Contractors Board under
Name ,_-�� �e✓ 6 _ previsions of ORS 701 and may be required to be licensed in the
-- jurisdicdon where work is being performed.If the applicant is
Address: .L_ exempt from licensing,t' 'ollowing reason applies:
City: _ State LIP:
Contact pclaon: + "Ian no.. —
Phone < S"S- F rx:
4:A o,""" 3r Contact person: Fees due upon application ........................... $
Address: ,a -f° Date received:
City: State ZIP: 97'» Amount received ...................................... .. $
Phone: -j`Ty Fax: E-maiL• Please refer to fee schsdule.
1 hereby certify I have read and examined this application and the Nd al iurirtkrimr Kcgm ctntit coda,Please call iurlaL-tion for mare Inromadon.
attached checklist. All provisions of laws and ordinances governing this U Vv-^ U MasterCard
work will be complied with,whether specified herein or not. Credit card numbs:
Authorized signature: =-��C-� " Date: --- Nune ar cardholder u af�wn on--c•ray cater
s
Print name:_ _. / �� "I cardholder atpurure Amoam
Notice:This permit application expires if a permit is not obtained within 180 days atter it htL9 been accepted as complete. 44o-4613(MCOM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
Associa,ed r trmits:
Cit of Tigard City of Tigard g ❑Electrics. ❑Plumbing U Mecriar,i^al
Address: 13125 SW Hall Blvd,Tigard,OR 97223 UOther:
Phone: (503) 639-4171 '
Fax: (503) 598-1960
I Land use actions completed.See jurisdiction criteria for concurrent reviews. _
_2 'Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of spFa caved plat/lot.
4 Fire district- _approval required. _^
5 Septic system permit or authorization for remodel. Existing system capacity _
6 Sewer permit. _
7 Water district approval.
8 Soils 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 fence design ar I 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 cannot he completed
_ if copyright violations exist.
I 1 Sitelplot plan drawn to scale.The plan must show lot and'nuilding setback dimensions;property corner elevations(if
there is more than a 44 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 bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,toom identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 (Toss sections)and detalls.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof consfructiow More than one cross section may be required to clearly portray construction.Show
details of all wall rnd roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulation,etc.
is Elevation views.Provide elevations for new construction,minimum of two elevations for additions and remodels.
Exterior elevafons must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation e'.evations 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 specifications and calculations to engineering standards.
17 Floortroof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and beating
locations.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."
19 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 bearn/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance.Identify the prec riptive path or provide calculations.A gas-piping schematic is required
for four or more appliances. _
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer 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 I I above. Site plans must be 8-1/2"x 11"or 11"x 17".
24 Two(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,reversed or mirrored building plans will be accepted.
27 —�
28
Checklist must be �:o,..nleted before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use only. 440-461e r60WOM)
Electrical Permit Application
Date received: Permit no.:
City of Tigard Project/appl.no., Expire daf_:
Cityu(Tisard Address: 13125 SW Hall Blvd,,Tigard,OR 97223 Date issued: By:t Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
=1 &2 family dwelling or accessory U Commercial/industrial U Multi-Family U Tenant improvement
New construction U Additiorvaiteiatiun/replacrment U Other: _ U Partial
Job address: '7d liJ 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 cont letion/ins Ilion.
Job no: Fee 11tax
�� A�( /l Descrl lion Oty. (ca.) Total no.lnsp
$usiness name: New resdentlal•single orn.alti-family per
Address: 0 O dwelWtg Ludt.Includes anached garage.
City: 1/ St9te' 'LIP: / Sery celncluded:
Phone: Fax: E-mail. 1000 sq.ft.or leas / 4
J��C Each additional 500 sq.ft.or onion thereof
CCB no.: �S� — Elec.bus. tic.no: �+ Limited energy,residential 2
City/metro lic.no.: ^T �_ Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electriclen re uired) nate Service and/or feeder 2
Sup elect.name(print); LicenseServices orfeeders-Installation,
alteration or relocation:
200 amps or less 2
Name(print): 201 amps to 400 amps 2
401 strips to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City; Statc. ZIP: Over 1000 amps or volts 2
Phone: Fax: E-mail: Reconncctonl I
Owner installation:The installatiot is being made on properly I own Temporary services orfeeders-
which isnot intended for salt,lea ie,rent,or exchange according to Installation,alteration, ;relocation:2(H)snips or less _ 2
ORS 447,455,479,670,70) 201 amps to 400 amps M _ 2
Owner's si gnatum: Date: 4n 1:,,ann amps - —2
Branch circuits-new,alteration,
or extension per panel:
Name: _ A. Fee for hratict:circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: V State: ZIP: _ B. Fee for branch<'rcuits without purchase
of service or feeder b e,first branch circuit: 2
Phonc: Fax: E-mail: Each additional branch circuit:
Mise.(Service or feeder not Included):
'U S.rvice over 225 amps-commecial U Health-care facility Each pump or irrigation circle _ 2
O Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
fi milydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel,
U System over 6tH)volts nominal more residential units in one structure alteration,or extension*
2
❑Building over,hree stories ❑Feeders,400 amps or more "Description: _
❑Occupant load over 99 persons ❑Manufactured structures or RV park FAch additional Inspection over the allowable In any of the alcove.
U Egress/lighlingplan U Other: Per inspection
Submit—sets of plaits with any of the above. Invcsd atiou fee
IMe above are not applicable to temporary construction_service. Other
Not all judsdicauu accept asst ca:dx,please call jurialiclidr frit mote information. Notice:This permit application
Permit fee.....................$ _
U visa U MasterCard / expires if a pertnit is not obtained Plan review(at %) S
Credit card number: !, — -_I L._ within ISO days after It has been State surcharge(8%) ....$
Expires ace-,pted m complete, TOTAI, ....... ...............$
.
Name of c tonrdf-�u flown nn c 't car �� $
Car der siartature -- `Amount 440.4613(&W=M)
Mechanical Perini t Application
Datereceived: Permit no.: a_; 60 D
City of Tigard Projec:Uappl no. Expire date:
C'ityof"fibard Address: 13125 SW Hall Blvd,Tigard,Olt 97223 __
Phone: (503) 639-4171 Date issued. By: Receipt no.:
Fax: (503)598-1960 Case file po.: Payment type:
Land use app.vvai: _ Building permit no.:
1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New construction U Addition/aheralion/replacement U Other:
SCHEDULE
Job address: -7 'i indicate equipment quantifies in boxes below. Indicate the dollar
Bldg.no: Suite no.: __ _ value of all mechanical materials,equipment,labor,overhead,
Tax mapltax lot/account no.: profit. Value$
Lot: Qloc;k: Subdivision: A Sec checklist for important application information and
Project name: juri,:diction's fee schedule for residential permit fee.
City/county: ZIP:
Description and location of work on premises:_ _ 11 OW Il
Fee(40 Total
Est.date ofcom completion/inspection:
Ue criplion Oly. Hes.onl Res.onl
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?U Yes U No Air con rt onmg(site plan required) —
Is existing space insulated?U Yes U No Alteration of exrsnng system
oiler/compressors
tate boiler permit no.:
Business name: IIP Tons BTU/H
Address- 'ir-smoke amper uctsmo a detectors
City; State: ZIP:_ — -neat pump(site plan require )
Phone.: -/� Fax: E-mail:
Install/repiacefurnac urner___ 1
Including ductwork/vent liner U Yes U No 61 Wo
CCB no.: nsta rep ac re ocate eaters-suspen e
City/nielro lie.no.: wall,or floor mounted
Name(please print): vent or a Tance other than furnace
Refrigeiration.
Absorption units—^__- BTU/H
Name: Chillers_._ ____ HP
Compressors HP
Address: Environmental exhamt and vent (on:
Stat ZIP: Appliancevent _
Phone: -- Fax E-mail: Drycrexhaust - '^f / 0
o s, ypc ITTITres Tcr:c ra .aimat
hood fire suppression system M
Name: Exhaust fan with single duct(bath fans) 204
y _ry- exhaust sy stem a art I`rom eaten or
Mailing address: Q -
ue p p g a ul on up to outlets)
City: S . .. Q ZIP: oil
Phone: Fax: Fuel piping e ad itiona I'M 4outlets
,ocean piping(sc rematic required) _
Number of outlets
Namc: _-- _---_—_- .--- ter Mqted appliance or equipment:
Decorativc fireplace
ZII':
Insert-type
City: State:
- W oodstoveipel let stove
Phone: Fax. E-mail other: -
Applicant's signature: -� Date: Other:--
Name
_ ter Name (print):
Permit fee.....................$
Nd VI i ritdktiau arespt crnUt cards,please call iurledkuon for,rare tnftxmatlan --
Notice:This permit application Minimum fee................$ 7 Z SC
U Visa U MasterCard / / expires if a permit is not obtained
Ctedit card number_._._._._._- —___�_�--_ --__l_.1— Plan review(at 96) $
ns rrs within I$0 days after it has been —z
tr State surcharge(896)....$ _ -
--- accepted as com I-re. TOTAL $ l
None of wdhold r u Shawn nn credit cud $ p P .......................
—�-� l'ardh tide,V6nature — ---� — Amount _ 4404617(6000C'OM)
Plumbing permit Application
Uatereceived: Permit no.:
City of Tigard
Address. 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit nn,;---
CiryoJTigard Phone: (.'03) 639-4171 Project/appl.no.: Expiredak:
Fax: (503) 598-1960 Date issued: Hy: Receipt no.:
Land use approval: -_M-, Case file no.: Payment,type:
I &2 family dwelling or accessory U Coin mercial/industrial Cl Multi-family J Tenant improvement
New construction J Addition/alteration/replacement ❑I-ood service J Other:
Job address:
'' I)esc:i tion Uty. Fee TotAl
��; �� - ,/ �_ ea.
Bldg.no.: Suite no.: New I-rind 2-family Astellhrgs only:
--- (includes 100 ft.fureaO.toili(yconnection)
Tax map/tax lot/account no.: SFR(I)bath
Lot: _ Block: Subdivision: d �1� SFR(2)bath — --- -
project name: SFR(3)math
City/county: _-_ Zip: -- Fach additional bath/kitchcn
Dccripdon and We ttion of work on prenuses:- Site utilities:
Catch basin/area drun
Est.date of completion/inspection:- Drywells/leach line/trench druid — - -
Fooutig drain(no.lin ft.)
Manufactured home uiilitics ' -
Bur inose name: 04
. �.G�� /! Manholes
Address: - l �_ � Rain drain con,tcctor --
Cily:r Still FLIP: V/..YQ Sanitary sewer(no.lin, ft.) - �-
Phon_ Fax:— _ E-mail: Storm sewer(no.lin. ft_)_
CCB no.: 6L' Plumb, bus.rc no; 3,V fT- Wa(ei service(no. lin. ft.)
_City/metro lir no.: Fixture or Item:
Contractor's representative signature: -` Absorption valve -
Print name: Dale: -"'- Ba"k flow reventer
p
Backwater valve
Basins/lavatory — _-- -
Name: Clothes washer
Address: Dishwasher
City: State zm Drinlu'ng four,ain(s) -
—��� Ejeclors/st'.113
_
Phone: Fax: E-mail: Expansion tick
Fixture/sewer cap -
Name(print): Fluor drains/floor sinks/Irub -
Mailing address; l -' Garbage disposal
Hose bibb
_City: , Stat LIP: ' Ice maker -
Phuuc9 Fax: L-mail: Interceptor/grease triter _
Owner insltilfatiunhesidential maintenance only: 71le actual installation Primer(s) -
will bt:made by me or the maintcnanee and repair made by my regular Roof drain(commercial)
emplu}ee on the property I own as per OILS Chapter 417. Sink(s),basin(s), ays(s) -- _
owner's signature: Date: Sump -
7'ubsh�hower/shower pan
Name: Urinal
Water closet
Address: ------,------ ---- _- -Water heater -- -
City: — State: ZIP: - Other: —
phane�_----_._.--_.._-
1`1 X: --- r� m il' Taal
-- -------, Muunturn fee................
Not ill ludsdica%au alx.elN cm&cards,please call luriuliakw t«nun infauutlon. Notice:'I his permit application
Visa U MastetC,ard expires if a pemtit is not obtained Plan review(al _ rc) $ - --
Cmdo card numbs: -� - -�_L� State surcharge(8`%)....$ _ .jet 1 L—
E><piroa within 180 days after it has been
TOTAL ...............
accepted as complete.
Nana or rardho�du d shown on c.alr:cmd p p
Cardbcldcr algn,uure - — AmOWt 44U 4616(60MOM)
114,
1 52 00' — -- — —
I LOT 12 I
I r - .- - -- -- - - - I ,
k5 �-
`� GAG aGF �
PROPOSED I
�I let-*'E RESIDENCC I
rl �? PLAN#1802
f�.�. a J
'vow[ •\I ¢4-THICK
CASE I R CONC p
arrxa l� 0 DRIVF.
— 50.32' O'09G
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7
U
78-5--"' S,W. KOSKI DRIVE
;Ik, ,
ECK
CONSTRUCTION
-- -� P 0. Box 204 °ur7 rc�
Stiurwood,OR 971,40
SUNTEL HOME DESIGN,NC IS NOT Qi-
LIABLE
FOR THE ACCURACY OF THE MAL DURd's TUl
TOPOGRAPHY iNFORMATICK IT IS -- _
rHE SOLE RESPONSIBILITY OF THE TO BE ATTACHED w�---
BULDER TO VERIFY ALL SITE Z
CONDITIONS,NCLUDNG ANY FILL :.
PLACED ON THE SITE,AND NORM
..,mss_
OWNERS OF ANY POTENTIAL FIELD "
MODIFICATIONS
t..
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 Signature Form
Permit #: rAST2002-00480
Date Issued: 1110103
Parcel: 1 S135CD-12500
Site Address: 11785 SW KOSKI AVE
Subdivision: KALAMOIIKA ESTATES
Block: Lot: 012
Jurisdiction: TIG
Zoning. R-12
Remarks: Const. new SF detached residence.
Your company has aeon 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, this completed form is received
OWNER: PLUMBING CONTRACTOR:
STEVE ECK CONTRUCTION NORTH STAR PLUMBING
PO BOX 204 1445 SE OREGON STREET
SHERWOOD. OR 97140 SHERWOOD, OR 97140
Phone #: 503-62- -1305 Phone #: 625-2679
Reg #: LIC 00090697
MET 00002694
PLM 34-255PB
AN INS( SIGNATURE IS REQUIR D ON THIS FORM
X
Sign ure of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WILLIAM BUTTERFIELD CONTRACTING
PO BOR 305
13120 SW MORGAN RD
SHERWOOD, OR 97140
Electrical Signature Form
Permit #: MST2002-00480
Date Issued: 1110103
Parcel: 1 S135CD-12500
Site Address: 11785 SW KOSKI AVE
Subdivision: KALAMOIIKA ESTATES
Block: Lot: 012
,Jurisdiction: TIC
Zoning: R-12
Remarks: Const. 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 t.le
appropriate 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
CAN NER: ELECTRICAL CONTRACTOR.
STEVE ECK CONTRUCTION WILLIAM BUTTERFIELD CONTRACTIN(
FO BOX 204 PO BOX 305
SHERWOOD, OR 97140 13120 SW MORGAN R^
SHERWOOD, OR 9714U
Phone 8: 503-625-1305 Phone #: 503-625-6173
Req #: Lit 118554
ELE 3-548(
title 30935
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Q ---
Signature of Supe +sing rician
If you have anquestions, please call (503) 639-4171, ext. # 310
/' CITE( OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00260
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/10/03
SITE ADDRESS: 11785 SW KOSKI AVE
PARCEL: 1 S135CD-12500
SUBDIVISION: KALAMOIIKA ESTATES ZONING: R-12
BLOCK: LOT: 012 .JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PRE\/NTrS: '
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 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 DRAIN: ft
Remarks: install irrigation backflow preventer, _
----— ------ FEES —--- --
Owner: __.--- - -_-�.-�_---- ---
Liesrription Date Amount
STEVE ECK CONTRUCTION ---
PO BOX 204 1I'LUM13i Permit Fcc 6/10/0:3 $36.25
SHERWOOD, OR 97140 ITAXI 8°G)state'rax 6/10/03 $2.90
Total $39.15
Phone : .503-625-1305 -`
Contractor:
GROVER'S LANDSCAPE SERVICES
26485 S. MERIDIAN RD.
AURORA, OR 97002 REQUIRED INSPECTIONS
Phone : 503-678-1796 RP/Backflow Preventer -
Final Inspection
Reg#: FIC 11807
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable (avis. 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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By: -11z -_ - _ Permittee Signature: el
-
Call (503) 639-4175 by 7:00 P.M. for an in:;pection needed the next business dad
i
Hunaing r fixtures
Plumbinp. Permit Application Received Plumbing
Date/By. y, 3 j',�'.__ _ Permit Ncrf.4 N b,UO3-c�p_,2_Li-
City of Tigard Planning Approval Sewer
y g Date/By: Permit No.:
13125 SSV Hall Blvd. Plan Review Other
Tigard.Oregon 97223 LaklHy - Permit No.: -
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
' Date/By: Cose No.:
Internet: www.ci.tigard.or.us Conrad __-� Jutie.: Seepage 2 for
24-hour Inspection Request 503-639-4175 Namc/Method Supplements[information.
- �- T PE OF WORK - FIX-SCHEDULE for special Information use checklist)
iJew construction Demolition Description -_�_ �t�• FCetea•► rr,ta:
Addition/alteration/rep]acement Other: New I-&2-f2mlly dwellings
_ CATEGORY OF CONSTRUCTION Includes 100 ft.for each u ility convection
SFR I bath 249.20
1 &:2-Family dwelling Commercial/Industrial -SF R 2 bath _ 350.00 _
r Accessory Building _ _Multi-Family _ SFR 3 bath 399.00 -
(] Master Builder _ Other: Each additional bath/kitchen 45.00 _ -
�- Jt)B S1-.'E INFORMATION anti LOCATION Fires rinkier-sq. fl.: Page 2
Job site address: / ; Y �- !� s' /��� Site Utilities
Suite#: Bldg./Apt.#: Latch basin/arca drain 16.60
Project Name: - Dr ell/leach line/trench drain 16.60
-- -- Fooling dram no. linear fl. Pae 2
Cross street/Directions oJa�site: Manufactured horne utilities 110.00 V
�Gb.I �c�nSr '1 Sof` J�
Manholes I6.60
Rain drain connecter 16.60
Sanitary sewer no, linear fl. _ Page 2 -
Subdivision: Lot#: / Z Storm sewer no I: ear ft. e2
Tax map/parcel #:
Water service no. linear R. Page 2
- Fixture or Item
OF WORK o valve_, _ 16.60
---
-�`t Backflow _.` Pa e 2
Backwater valve 16.60
Clothes washer 16.60 _
-- --- ---- - - _--- Dishwasher 16.60
PROPE - T
RTY OWNER 1NANDrinkingfountain 16.60
--- - ��--- r- T F.jectors/sum _ 16.60 _
Name: �, G- ( c ; iz. y.�r Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/Zip:
- --- Floor drain/floor sink/hub 16.60
- --- - -- - -- - Garbage disposal 16.60
Phone: Fax: Hose bib 16.60 _
APE
PPLICANT CONTACT RSON - 1c,maker 16.60 _
Name: _ 4 - Interce tor/ tease trap _ 16.00
Address: Medical gas-value. S ,-_ Pae 2
Cit /State/Zi ' Primer _ 16.60
- ---- ----- - - Roof drain(commercial) I6.60
PI one: --�_ FaX: Sink/basin/lavatory _ 16.60
E-mail: Tub/shower/shower pan 16.60
T CONTRACTOR Urinal 16.60
_Business Name: Zc`✓c>��_L S Al Water closet _ 16.60
Water heater 16.60
Address: C •r'� S' y �zf,� ,y.�-�*► rz - Other---- - - --
Cit /State/Zip:_ rt•.9 ea--6 Other -- ---- -- - _
Phone: 54 S f 6 Fax: - ermitFteu- _
CCB Lic. #: . f¢c/ Plumb. Lie.#: ---_ Subtotal S
Minimum Permit Fee;12.50 S-
Authorized bate��� ,�/? Residential Backflow Minimum Fee$36.25 _
Signature: = _ _-_- J Plan Review(25%of Permit Fee) S
` f / ✓E'�Z�--- State Surcharge 8%of Permit Fee S
(Please print name, TOTAL PERMIT
Notice: This permit application expires If a permit is not ohtained within SII new commercial buildings require 2 sets of plans with Isometric or
180 days after It has been accepted as complete. riser diagram for pian review.
'Fee methonolog} set by Tri-Counly Building Industry Service Board.
ODstsTetmit Fonts\PlrnI1crtni1App doc 01103
Plumhina Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Dire Sup session Sysoems:
Site Utilities_ Qly. Fee(ea) Total Square Fuota e. Permit Fee.
foonng drain- I" I W, 55.00 0 to 7,(x;e -- $11500
I cooling drain-each additional I NY 46.40 2,001 to 3,600 — — $160.00
, --
Sewer- I st IOD' 551601 to 7,200 5220
.00 .00
7 2)I and greater— $309_00
Sewer-each additional I M, 46.40 —
Water Service- I st 100' 55.00
Medical Gas S 'stems:
Water Service-each additional 100' 46.40 _ Valuation: Permit Feet
Storm&Rain Drain- Ist 100' 55.00 $I.(N)to$5,000.00 Minimum tee$72 50
Slim&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$6.52 for each
Fixture or Item Qty- Fee(ca) Tofal additional$100.00 or frac,'...'hereof,to and
C'ommcrcidl hack I low I'rcvcnuun Ikvice 46.40 including$10,0W.00. _
$10,001.00 to$25,0(10.00 $14ft.50 for the first$10,006.00 and M.54 for
Residential Harkflow Pre%ention Device each additional$100.00 or taction thereof,to
(minimum permit fee,$36.25) 27.55 _ and includin $25,000.00.
Rain Drain,single family dwelling 65.25 $25,001 00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Inspection of existing plumbing or each additional$10.00 or fraction thereof,to
s e ially requested inspections-per hour 72.50 and including$50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
-- _ each additional$100.00 om fraction thereof.
Fixture Worl::
Are yott capping, utoviuf;or replacing existing lixfures? If
"yes",please indicate work performe(I b'v fixture. Failure to
accurately re►ol_t lixfures coin(] result in increased sewer fees".
Cuantil by Mitturc)Wnrk Performcd (oilmen(~ regarding fixture work:
Fixture Type: Replace
_-_--- New Moved-
lis it tistry/1 on( -
Bath -Tuh/Shower --- - ------ - -- ._._..--_ --
-Jacurci/Whirllwul
('or Wash -Each Stdll — - -
-Drive T'hru -
C.s idor/Water Aspirator
Dishwasher -Commercial -
-Domestic -- -�-- -- — - -
Drinking Fountain -- - - —Eye Wash ——
Flrwr Drain/sink -2" - -- ---—-Y — --- --- ----- _ _�_.
4"
Car Wash Thain
Garbage -Domestic *Note: If the fixture work under this permit results in an
')isposal -Commercial — _ increase of Newer F:UI's, a sewer permit %fill he issued anal
-Induslripl +– fees assessed 101•file se%%er increase must he pai(1 before fill-
Ice Mach./Rcfrig Drams _– plumbing permit can he issued.
Oil Separator Gas Station)
Rec.Vehicle Dump Staten
Shower -Gang —
_ -Stall --- -
Sink -13ar/Lavatory
-Bradley -
-Commercial --
_ -Service
Swimming Pool Filter
Washer-Clothes_
Water lixtractol
Water Closet-Toilet
Urinal _
Other Fixtures:
i:\Gsu\Perinit FolmsTImnPermitAppPj;7.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 —___ PUP
Louation _ _7_ - — _Suite_ —_ MEC
Contact Person --_ _—_ __.. —___- Ph(---) . --___ PLM - -
Cuntractor____�_-__-- _ _� __-__ Ph(- -) ----_--- -- _. SWR
BUILDING Tenant/Owner ELC — —
Footing ----- - ELC ---___--
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Pest& Beam -- ------ --- -- .- - --- -- ------
Shear Anchors ---------------_-_
Ext Sheath/Shear --------------- --
Int Sheath/Shear
Framing ----- -- -- --------- - --�--.- --- --- ---- - - - - --
Insulation
Drywall Nailing --.... ---- - - - --- ----- -- - .. _ - - ----- - --
Fireweil
Fire Sprinkler _____-----_-_.-
Fire Alarm
Susp'd Ceiling - -- - —_ - - - - - - --
Root G
Other:
Final '
PASS PART TAIL
_-
--PLUMBING -_— __ __ _-- _—_---_-----------------------__-- _.._-- -- - --. - -
Post& Beam
Under Stab ----
Hough-In
Water Service ---- - - - _ -- - - - -------- ------- --
Sanitary Sewer
Hain Drains ---- _ _- - ---_ - ------- - - ----- -Catch Basin Basin/Manhole
StormDrain --------_..- __-_ _ ---_._..---------- ---_-_._--_----__.--
Shower Pan r
Other.
ri
S PART FAIL
CHANICAL — - —�. _----- ---
Post& Beam
Rough-In - --- - - ------ -- -__ - -- -----"-
Gas Line
Smoke Dampers -- ---- _ - - - --------.�--- -- . -
Final
PASS PART FAIL - - ----- -. ._ - ----- - --- - -- -
1=LECTRICAL
Service
Rough-In
UG/Slab
Low Voltage - - -- .. - -- - - --- - - -- ------ ---- -- - - -
rite Alarm
Final Reinspection fee of$_ _---_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
-- -- Unable to
SITE � Please call t r reinspec,.ion RE: inspect-no access- _- -_- - ----_-- ----
Fire Supply LineAA
Approach/Sidew.Ik Date w - - Insper for / / -__- - Ext
Other: _
Final /DO OT REMLIVE th12 Inspection record from the Job site,
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspe^.tion Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP _ —
Received - Date Requested___-0 AM—_�'PM__._-__._ BUP
Location ____--!J1 _^— .-Suite.__ MEC
Contact Person __ _ __ Ph PLM
Contractor -- —__---____-- Ph SW9 -
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 67 l� �rti`Cy
Fire Sprinkler
Fire Alarm �� 0f
Susp'd Ceiling — - -- - . ---- ----- -
Root
--- ---
&'Fin
PART FAILINQ - _ ---- - ------__
Post& Beam
Under SU b ---- - -- —_-- --- --- ---- - - -
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 ----------- - _ - - -----------._. - -- --
f✓lii �
PART _FAIL -- - ------------ - -- __.
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final �_ Reinspection fee of$-_-- required before next inspection. Pay at City Hall, 1,3125 SW Hall Blvd
PASS PART FAIL __
----
SITE --� Please call for reinspection RE: [ Unable to inspect no access
Hire Supply Line r " ?
Apprc a,.h/Sidewalk Date `'_-_-_. Inspe0or ____--- -- Ext _--
Other:
Final - DO NOS' REMOVE this Inspection record from the job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
SUP ---
Received �._ / / Date Reques�d _ S _ AM.— PM___�_. BUP
Location .-----I —Suite MEC
8$G
Contact Person ________—_^__,.. _____�______ Ph(.__.—_) _._ —3_7 7 /—. PLM _—.—
Contractor —._ -- ____.. __.- -- Ph(_--) __-- __-- SWR ---- _
BUILDING Tenant/Owner _—._______ __-_— --__--� — ELC
Footing ELC --
f=oundation Access:
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam --
Shear Anchors � ----- --_._--------.....___
Ext Sheath/Shear
Int Sheath/Shoar
Framing - ------ -- ------- _--_ ----------- - -----
Insulation
Drywall Nailing ----- -- - -- --- �. ----- -- -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Root - - --
- _ -------------------------
Other: ---- -- - _ -
Final
_PASS_PART FAIL
PLUMBING -- - _ 1 - -- -------- - _._- --
Pest& 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 ABeam
Rough-In --- - --- - ------- -_ - --
Ras Line
Smoke Dampers --------- - —._._.. --- -- ---- - - ---.�
Final
PASS PART FAIL -- - -- -- - .. - - - -- ---- -- -- -
ELECTRICAL
Service _-- ------ -
Rough-fn - --- - ----- ----___ — — - ------- - -
UG/Slab
Low Voltage � �- ' �- ---- --- -- --- -
Firo Alaim
r
� U Reinspection fee of$ _ — re b9
fore b_fore next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
_
PART FAIL
SITE [ I Please call for reinspection RE:._,_. -________ ___._ � � � Unable to inspect - no access
-- - ---- ----
Fire Supply-- Line _
ADA
Approach/Sidewalk Date Inspecto ______ �f ��" - Ext
Other.
Final DO NOT REMOVE thle inspection rocord from he job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Invection Line: (503)639-4175 MST 4U
INSPECTION DIVISION Business Line: (503)539-4171
_ BUP
Received _ / Date Requested _--_ —15"
_ AM----PM BUP
Location _ �1L � �= �� ___Suite MEC - --
Contact Person 7 77 PLM ��..
Contractor Ph SWR
_BUILDING _ Tenant/Owner __-___.__ ___�,�_—_____ _ — ELC
Fooling
ELC
Foundation -_-.-__- ----.--_-
Access:
Ftq Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam —_^_--
Shoar Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing --_.__—
Insulation
Drywall Nailing -- --- ----- --�---_ �--___
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P_ASS_PART FAIL -__-�_-- .--___-----___- -----_.—__
PLUMBING —
Po,, : Beam M -
Ur� Slab
Holjgh-In
Water Service -- —— -- -- -- ... -- --- ------- ---�—
Sanitary SAwer
Rain Drains ---- -- -- — - ---
Catch Basin/Manhole
L'torm Drain
Shower Pan
Other: -- — ---
A PART_ FAIL �`�______—_----- - - - --__-- ---- ----- ---- •-
__HANICAL
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 __- -__ ___ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE —.___._____—___- Unable to inspect- no access
Fire Supply Lina / or ns
ADA Date 5 - -. IeCt '
Approach/Sidewalk — - P Ext
--- -
Other:---- ----
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL