16210 SW KEERINS COURT y
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,_ 1.6210 SW KGRRCAV S COURT ,�..
CITY CSF TIGARD
DEVELOFMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
CI''CC'JPANGY
PEA,AIT 10. . . . . . .
SITE PDORLSS. . . lCallb SSW L(ERRONIS CT
SUS0 I V IS.*ON. - . . KEPRON' 5 CREST NO. Z ZON I NG r R -J.
BLOCK. . . . . . . . . . s LC17 . . . . . . . . . . tO71 A J R 1.S Q I C T I ON s UR P
CLASS OF WORK. sNEW
TYPE OF" USE. . . I SF
TYPE Of` CONSTP 5N
OCCOPANC � CAP. zR_3
OCCUPANCY I. LJAD-.2
Rema k ,i %
P C DEVULLOOMENT INC
Phone #r
Con-tro
ROCKWEI .L., SkOLIGHTON INC
PO BOX 757
SHERWOOD OP c) '.40
Phone ot 625-0685
Reg 11. . 1 10010,54
Thi % Certifirmte grantn o,-.c:.,ipjknry of the w. -ve refelf-etlVfmd I. Milding or portion
theroof and conf. rms that the buildint
y hat?, Peen 111PPected for compl. tarics wilrli
the Ste',-P of 0?-*[ju" 3pvcielty Code% fcr the gro'.1p, c)cc,1.q)a%ncyj and u%e �tnc
h �ey-
wi.r7h the referenced permit v)^v issup,J.
53LIPERV10O.R
P097 IN LONSPICIm'Ur) p*t_(4CP
CITY OF TIG ARD BUILDING INSPECTION DIVISION
24-Hour Inspcow ',tne: 639-11,5 Business Phone: 6394171
p
Date Requested:// M. 'M�J�x_ MST: 05 Z �O
location: I(CJ ZI t .f,f t J
— - Ii1;JP:
Tenant:_ //Suite: /Bldg: MEC:
Contractor: 61,-,IA 111N-/ Phone: Zy7 i ��_ PLM: . —
Owner:___ l/ Phone:
_ Ei,#C;
--- _— EI.R;
_ SIT: _
BUILDING BL (con't) PLUMBING (_WCHANICAL I ELECTRICAL, SITE —v
Site osUBeam Post/Beam PJsWcam Cover/Service Sewer/Stonn
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Too Out Gu,Linc Rough-In UG Sprinkler
Foundation Insulation Sewer Flood/Duct Reconnect Vault
Rsmt Damp lhywOl Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UC Slab
Shear/Sheath Firc S kh/Alm CrawUFound Dr Ileat Flunp Irw Volt
Epp�/Sllk
uroved) Approved pprovc Approved Approved
T7�S p' o%,:(I Not Approved / of A�j�roved Not Approve Not Approved
_.� FINAL d K `f'1/7 -�'IFIAI,J /'C FINAL dFINAL
M Call for reinspec ' n Reinsp xtion fee of S ._required before next inspection C3 Unable to inspect
Inspectot -- - Date: :___� � Page_ of —.�_
Page No. 4 CASE HT9TORY FOR CASE NO.: 05081-260
ROCKWELL-BROUGHTON INC
16210 SW KERRON'S CT
06/17/98
Action Descripticn Req/ Schd/ End/ Action Noten Disp By Update Upd
Code Sent Dare Done Data By
K%TA770 Mise. Inspection / / / / V+/UR/98 Courtesy nits visit. Handrail NOTE fi.9 04/09/98 J-H
interpretation.
MSTA790 Electrical Final / / / / 04/16/98 final approved PASS CD 04/lf/98 CD
MSTA795 Mechanical Final / / / 04/21/98 see bldg final. FAI1. KS 04/22/98 J+H
MS'1A795 Mechanical Final / / / / 04/22/99 1. Slope fininh grader away from PASS KS 04/23/48 J•H
utructure at sides and rear an weather
pettniI n.
MSTA797 Plumb Final / / / / 04/15/98 1. No hot water to test fixtures. FAIL WA 04/15/98 J*H
2. Install permanent cap or raindrain
riser at entrance that in not used.
3, Locate low point drain, water nnder
building.
MSTA797 Plumb Final 04/17/98 / / (A/1.'7/98 Approved an noted: PASS WA 04/19/98 J"H
1. Items or inspection report dated
041598 have been corrected.
2. Back water valve for LP drain in
crawl area okay.
MSTA797 Plumb Final. / / / / 04/16/98 Cancelle.. CANC WA 04/17/98 J*H
MSTA799 Building Final / / / / 04/21/98 1. Support gas pipe At horizontal FAIL KS 04/22/98 J*H
section and water heater
2, Provide clearance at b-vent
horizontal.
3. Support flex gau pips at kitchen
range.
4. Provide handle at cra,, c%eon.
5. Support heat ducts at crAWl space.
6. Remove debris and reco• tr vapor
barrier at needed,
7. Add bolts poet/header connection
at extericn .
e. Sail (voidl above entry at exterior.
9. Grout around retina lines at AC unit.
ext.
10. Slope finish grade away from
structure.
11. Need final erosion control approval.
MSTA799 Building Final / / / / 34/22/98 PASS KS 04/23/98 J*H
Page No. 3 CASE HISTORY FOR CASE NO.: 05081-260
ROCKWELL-BROUGHTON INC
16210 SW KEPRON'S CT
06/17/96
Action Descrlpti.c,n Peq/ Schd/ End/ Action Notuu Diap By Update Upd
Code Sent Doose Done Date By
MSTA726 Shear Wall Insp / / / / 02/09/98 1. page 15 of engineering- page 4 FAIL RB 02/01,;,9 PB
straps at garage headers
2. nail D wall at electrical panel
3, nail sheathing to bottom plate at
dining, living
4. H-wall in<ompleted %:/o sheathing
(after insul tion-ok)
5. page 4 of engineering, P well a-35
brackets at 48" etre
6. page 14 catilever, a-35 brackets at
48" etre
7. nail platen at 6" c'-ra at 5 F 6
issues.
MSTA126 Shear Wail Insp / / / / 02/10/98 Approved as noted: Shear wall $T5 PASS FS 02/10/98 J*H
adjacent to front entry n-vt done at this
time; call for inspection when
completed.
MSTA727 Low Voltage / / / / 02/17/98 rougt in only approved PASS BRP 02/2.4/98 J•H
MSTA727 Exterior Sheathing Insp / / / / 01/22/99 PASS RC 01./22/98 J•H
MSTA735 Gan Line Tnep / / / / 02/17/98 See roughin nech inap this date. FAIL FS 02/24/98 J*H
MSTA735 Gan Line Inap / / / / 02/25/90 Gan piping PT test 1 30 psi PASS KS 02/27/98 J•H
MSTA740 Insulation Insp / / / / 03/03/98 PASS FS 03/04/98 -J-H
MSTA740 Insulation Insp / / / / 04/03/99 Ceiling insulation P;.63 PC 04/05/98 DGW
MSTA745 Gyp Board Insp / / / / 03/06/99 PASS TLP 03/09/99 J•H
MSTA755 Rain Drains / / / / 01/2^/97 APPR 05/31/97 WAC
MBTA760 water Line Insp / / / / 02/01/99 Water linea okay, DWV fittings i water PASS DD 02/10/98 J*H
tent okay.
MSTA760 Water Line Innp / / / / 03/17/99 PASS TN 03/22/98 J•H
MSTA765 1ppr/sdwlk Tnnp / / / / 04/21/98 PASS MH 04/22/99 J•H
MSTA770 Misc. Inspe-tion 12/29/97 / / 12/24/97 NOTICE+ The last inspection on this NOTE RC 12/29/97 JT
permit was performed on 1/29/97. An per
Sec 111.3 of the State of Oregon One R
Two Dwelling Specialty Code, a permit
shall expire by limitation if work in
suspended or abandoned for a period of
nix months or more. Please call for an
insouction or apply for permit
extension. Please make above correctionn
on or before Jrn 15, 1999
Page No. 2 CASE HISTORY POk CASH NO.: 05081-260
ROCKWELL-9ROUGHTON INC
16210 SW KHRRON'S CT
06/17/98
Action Description Req/ Schd/ find/ Action Notes Diap By Update Upd
Cede Sent Done Done Date By
------- ------------------------------ -------- - ------------------------------- --- ---- --- -------- ---
MSTA723 Electrical Service / / / / 01/30/99 supervising electricians •2gnature an PASS HRP 02/01/98 J*H
application
OK TO INSPECT
Bxces,live box setback - many locations,
low voltage not installed, gar opener
wiring - pass. No fan l-xos.
MSTA724 Electrical Rough In / / / / 01/30/96 supervising electricians sign .-ure is an PASS BRP 02/01/98 J*H
application
OK TO INSPECT
no f.%n boxes
MSTA725 Framing Inep / / / j 02/19/98 Call for reinspection: FAIL RB 02/26/98 J*H
1, Ciao line test approved. 30 psi, tag
321397.
2. Isaues 2,4 & 5 from Mechanical
Inspection of 021798/KB not corrrected.
3. Close off return air -has* from
un-rated wiring for plenum.
4. Nail plate pros-+c#. dr,•er vent.
5. Stair trend at winder needs to be nc
lean that 6-inch minimum.
6. B-ock stair case.
7. Secure fireplace into palace.
9. Add strap at small opening 2x4 to
2x10.
9. Add bolt to glu-lam bracket in
garage.
MSTA725 Framing Inep / / / / 02/25/98 1. Pill voids ext. wall at t,1b. Also at FAIL KS 02/27/98 J*H
soaking tub.
2. Remove insulation touching b-vent.
3. Provide installation manual for
fireplace.
4. Complete framing corrections.
MBTA729 Framing Tnsp / / / / 02/27/99 Fleming corrections made per RS :ist PASS KS 03/01/98 J*H
.!%ted 021998.
MSTA726 Shear Nall Inep / / / / 01/15/98 Consultation - work in progress. NOTE RC 01/19/98 J*H
Page No. 1 CASE HISTORY FOR CASE NO. : C5081-260
ROCKWELL-BROUGHTON INC
16210 SW KERRON'S CT
05/17/90
Action Description Schd; End/ Action Notes Disp By Update Upd
Cede Sent Done Done Date By
------- ------------------------------ -------- ------- ------ ---------- ------------•-- ---- --- -------- ---
175
—175 Set Backs / / / / 11/07/96 APPR 00/31/97 WAC
MOTA005 Application received / / / / 05/24/96 DONS WC 05/21/97 WRD
MST'.010 Check for prel. restrict. / / / / 05/24/96 05/21/97 WFD
MSTA094 WACO issuance to change statue / / / / 05/30/97 PASS IN 05/30/97 LN
MSTA125 PERMIT EXTENSION REQUEST / / / / 01/15/90 extension granted until 5/33/98 per 01/15/98 ,1T
David Scott
MSTA150 Return permit to ISSUED status / / / / 04/17/90 CD srroneoualy case finaled when he PASS HAP 04/17/98 DGW
entered final electrical
approval..,.. ..deleted line
entry...returned to issued
status......hap
MSTA700 hrosion Cont.ol / / / / / / 05/21/97 WR.0
M.9TA703 Grading Inspection / / / / 02/09/98 Site looks gcx>d, ok PASS ?I 02/10/98 J*P
MSTA'104 Sewor .nnpection / / / / 04/10/98 3-inch ABS sanitary newer okay, tested PASS WA 04/12/98 J*H
to o✓srf.low with water.
MSTA705 Footing / / / / 11/07/96 APPR 05/31/97 WAC
MSTA706 Foundation / / / / 11/29/96 APPR 05/31/97 WAC
MATA710 Structural Post & Beam / / / / 01/28/97 APPR Ob/11/97 WAC
MSTA711 Mechanical Post 6 Beam / / / / 0i/28/97 APPR 05/31/9
MSTA713 Crawl Drain/Backwater valve / / / / n4/17/98 PASS WA 04/19/90 J*H
MSTA717 Plumbing Post 6 Beam / / / / 01/LB/97 APPR 05/31/9" WAC
MBTA720 Mechanical Insp / / / / 02/17/99 1. Framing at fireplace not done. FAIL KS 02/24/98 J*H
2. range vent not done.
3. Provide insulation shield at b-vent
attic and extend above insulation.
4. Seal joints at return air supply at
floor cavity.
5, support clothes dryer vent.
MSTA720 Mechanical Insp / / / / 02/25/98 1. Remove insulation touching b-vent. FAIL KS 02/27/98 J*11
2. Provide installation manual for
fireplace.
MSTA720 Mechanical Insp 01/04/98 / / 02/27/98 PASS KS 03/04/98 J*H
MSTA722 Plumb Top Out / / / / 02/10/98 DWV fittings i water test okay PASS DD 02/10/98 J*H
MSTA722 Plumb Top Out / / / / 02/11/ approved 021098 PASS WA 02/11/98 J*H
i
RESIDENTIAL PERMIT APPLICATION
WASHINGTON COUNTi, BUILDING SERVICES PROJECT NO.
DEPT. OF LAND USE AND TRANSPORTA'T'ION
155 N. 1ST, #350-12, HILLSBORO, OR 97124 PERMIT NO.
003) 640-3470 FAX (503)68'-3993
i'ICASe ))r of t l' n ()rn'(11 On clear
�- y , or last -nnd accurate com=)DRFSS
uter etrlry,
DEVELOPMENT: c; 1���
./ Al FF;Er !YES) (NO)
ADDRFSS: r
TY:
TAX MAP AND TAX LOT# '1VA 3 ,` ►
DIRECTIONS TO SITE: -
..�•_`��.1.A,hC ' .`_; I•is �u ..►. . iL,��`i_l M-1 � r�-�-3 ..t Mr.. 1 �C4 i a `l �_ Li w 5C r�. ,A_.i { Oea=��'�"ty
TIIOMAS Mita' PAGE; NO.
RIKSIDF,NTIAL PROJECT DE,SCRirI70N:
rCACh FII,F N0.
(Pirssr circle appropriate caterory/les) I I'LAN '1'O:
uiiq (add to) (remodel) (demolish) a (r,Nj (rxlstinA) (accessory)(farm) huildinK at file alwrve site. ESTIMATED VALUATION:
_..
ARTA OF SQUARE RX)TAGE IN: 2NDFLOOR: )
..j .Z ARD FLOOR:
CARPORT: GARAGE: C — --
1►ASI-'MFN1- "A 11ONUS ROOM: !�
NO. or BFDROOt►1S: 1 MANUFAC'fUkri) UOml.'! (rhtvk whether)
N(1. OF ItAT11RUOMS: SINGLE ,)OUIII,E TRII'lx (jUAD.
NtECIIANICAL 1t'OkK 61rci(N(1► N(1. OF FURNACES: I AIR CONDITIONER (YES) N!)
PI,1JAtBING 1VORk YES► (N(►) - ELECTRICAL WORK YF. (No )
I'Ro I'r,RT1' 01t'NEk:'R"-A--w
I'l lONE:3b} L
ADDRESS: C' t)t 75.
711' CO1►F: Ca
F,NGINEER/ARCIIITE CT!1)ESIGNCR: -
�b 1 G,Sl, wi I
kF5S: 1 j �.o Jfi I` `1�' Z
DESIGN NO:
� kl;-ISSl.1F;:
RUILDrRICONTRACTOR: -
r
PlIONE
ADDRESS: ,3 f� ! � --t--- 4�.LS —CSG�fS
IIII 75 ? .�'k 6- L -."- f_ +u... 7.IP CODE: ..71 ern
LRIJILDF.RS BOARD NO: "I '
t� y
EXPIRATION DATE: N /•j� d /�.
NOTES: To ohtair -our permit you will vend fire Following: 1) App-oval for your :eplic sytillxrr from the Health Deportment r,r
approval In inar.,ll your sewer From Unified Sewerage Agency (USA), 2) (•) Electrical permit upplicatilm filled out by your
electrical contractor, i) (+) Plurnhing permit filled out by your Stale l
p!urn'ring contractor.• (a Unle�: aw allows you Io take out
Ihese permit%.)
This applicafiod, together %vith the plan;, specircil(ions, and exhibits, comprise the application. Fake or misleading information
Ilia he grounds nds for invalidating u permit. The upplirnnl is respnnsihle For compliance to all applicahl_ codes. Lund Developme,
Servicc%' checkinK the plans for Compliance to building codes and coordinating Frith other departments. does not relieve the
applicant or this respomsihiiii1
1y--
NAFotE OF APPLICANT: J GN IJ ,t
REPRESENTING:'
ti
I have read and Bret slilh these conditions:
SIGNATiIR{s
WASITINGTUN COUNTY -- DATE. -7
EFFFCTII'F
WASHiNG-f ON COUNTY RESIDENTIAL
Department of Land Use & Trnnsponation
Plumbing inspection rection PLUMBING PERMIT
155 North First Avenue, #354-12
Hillsboro, Oregon 97124 Project/
Information: (503)640-3470 Fax: (503) 681-3993 Permit Number Date
Inspection Requests: (503) 681-3699 or 681-3,598 -- �-
Permit Fee Schedule
PLEA.IE PRINT • om'llleie all sections. DESCPIPTION QTY. I COST(Ea.) AMOUNT
RESIDENTIAL- SFR(1) BATH $210.00
erne of Deveio sept ` NEW SFR(2) BATH 275.00
Joh =40-- Lc�A� rlo, _ SFR(3) BATH_ 325.00
Address SINK(KITCHEN) 9.00
Address 166,-,0
Map No. TaK Lot WATER HEATER 9.00
_ (v6 .15A.00g_ DISHWASHER 9.00
Thomas age Section DISPOSAL 9.00
Map Book ( t►( WATFP CLOSET '- 9.00
Directions to Site BASINS 9.00
or Cross Street SL�p ,Q,,�.t -- -
------ TUBS 9.00
J ��. SHOWERS_ _ __ 9.00
CLOTHES-WASHER - 9.00
�CbC�cv►��+�.�- Co LAUNDPY TRAY 9.00
o P Jlinc Address Misc. _ 9.00
Owner 0 ?' - - --- REMODEL EACH FIXTURE
;y/State Zip (minimum fee-$2.5.00) _12.50
_X;6" ,r"I>- DAK.--_7 7
Phone FLOOR DRAINS _ 9,00
b Z 5-- b(p g Ste" RAIN DRAIN/DOWNSPOUT _9.00
Arne �� � DRY WELLILEACH LINE _ 10.00
to WATER SERVICE first 100' 30.00
Mailing Address WATER each addnl 100' 25.00
� f REPLACING in building
Contractor
Sta;e Zola
700 7 water supply lines
FIRST FLOOR 30.00_
�s U 3 ADDN'L FLOOR -each 12,00
,,list,, . i No I Plumbing Lic. No. SAN. CONNECTION
_I f 'Y 3-i, 3y7_I_dott SE=WER _first 100' _ _ 30.00
1 hereby acknowledge that I have read this application,that the each addnl 100' 25.00
Information given Is cot,c^t•thof i am the owner or authorized
agent of the owner,that plrns submitted are In compliane with seperate permit to prevent
State laws.that I am registered with the State Builders'Bnard,thAt two contractors from working
the registration number given is cot rect. (If exempt from State
registration,please give reason here.) off some permit 40.00
eAc�i LO v MANE-WP_ 9,00
STORM up to 4' diameter_-per 100' L 10,00
SEWER over 4"diameter-per 100' 15.00 _
Tor ea. addnl 10u'-� 30.00
1'i r,� CATCH BASINS/AREA DRAIN _ 10.00
MOBILE HOME UTILITIES 60.00
ut razed Signatut- - a c INSP. OF EXISTING PLUMBING
- - - ---
Describe w:rk rAR-MINIMUM
per hour _ _ 40. 0 _
to be done Xnew ❑addklon [J alteration ❑repair SOL _ _ __ - 30.00
� HEAT EXCHANGE9.00
COLLECTOR PANEL _ 9.00
NOTICE: TANK _ __ ---------- _9.00
This permit becomes null and void if the work MINIUIUM FEE 25.00
or construction authorized is not commenced _ SUBTOTAL
within 180 days, or if construction or work 5% of subtotal for State Surcharge
authorized is suspended or abandoned nt any TRUST ACCOUNT TOTAL FEE DUE
time after work is commenced.
1308.8185
WASHINGTON COUNTY RESIDENTIALDepartment of Land Use &Transportation
f1,� Mech anical Inspection Section MECHANICAL PERMIT
155 North First Avenue,#350-12
Hillsboro, O�Egon 97124
Informat+nn: (503) 640-3470 Fax: (503) 681-3993 Project/Inspection Requests: 503 681-3699 or 681-3698 Pern , N AmberV "`��406 Date 1 V 2 k
G=_ PERMIT FEE SCHEDULE
Nar a cf Qevelopm t --- - --- 00
PERMIT ISSUANCE FEE 10.00
leu
= � ---
Addreas DFSCRIPTION OTY. COST(Ec) AMOUNT
FURNACES
up to 100,o0o8TU 6.00
Map No, Tax Lot including
- -- —.
Jab ductwork over io0,000BTU 7.50
Addresto Map Book `4 - Section- and vents - FLOOR 6.00
Directions to Site HEATERS suspended,wall o floor-mounted 6.00---
or Cross Street tA IIIS C_i.0.QL%-rM AIR HANDLING u ,o 10,000 CFM 4.50
--- UNIT —
'CLF� �S 41R CONDI rIONER over 10,000 CFM 7.50
-----
A,W_ TU
ame (nr Naine of Business) "'ATF MP 7.50
ALTER EXISTING SYSTEM 4.50
Mailing Adu,ess
_ REPAIR OF EQUIPMENT LISTED ABOVE 6.00
Owner City/State Zio Non-portable EVAPORATIVE COOLER 4.50
fn— � me%
Phone VENT FAN connected to single unit 3.00
--- —
t
.I_ k6(� � V°NT not Included in A hanra Permit 3.00
Name VENTILATION SYS(EM not incl.A .Pmt, 4,50
f.'t d 77/�/v -1-A-Z:..
----
Mailing Addre s -A b 'e3 O tC '� HOOD served by mach,exhaust 4.50
� �� , r ytZ=Eya0 R'D ro �. DOWN DRAFT FnR RANGE 3.00
Contractor Cit /.Mate Zip
WATER HEATER VENT 4.50
phone INCINERATORS domestic We 7.50
AnL* 9 �� -- -- WOOD STOVES FIREPLACE 4.50
tate --
Registration No. SOLAR SYSTEM 450
r hereby acknowledge that I have read this appilcatlon, CLOTHES DRYER 4.50
that the Information given Is correct, that I am the owner GAS PIPING 1 to 4 outlets 2.00
or authorized agent of the owner, that plans submitted J
are In compliance with State laws, that I am registered each additional .50
with the state Builders' Boara, that the n-gistration OTHER _
number given Is correct. (If exempt from State registra-
tion, prease give reason here.) OTHER
SUBTOTAL
rte` s 5%of subtotal for State Surcharge
Prt ❑ TRUST ACCOUNT
Receipt No TOTAL FEE DUE
A orh_cd Signature ate -
_ __ _ __ _ APPROVED BY
Describi work ,Cy1 new []addition CJalteration ❑repair _ —--- --
to be dove K
Date — Date
Submitted _ Issued ._— By — •—•—��
NOTICE: This permit becomes null and
void if the work or construction authorized
is not commenced within 180 days.
or if construction or work authorized
is suspended or abandoned at any time
miter work is cornmenced.
BL27 •9195 ����
WASHINGTON ELECTRICAL PERMIT
Qepf*rtment of Lsad:td Use ae&Transportation M IT
Electrical Inspection ,#3 n
155 North Oregon
Avenlue #350-12 APPLICATION
Hillsboro,Oregon 97124
Information: 503 640-3470 Fax' (503 681-3993
PLEASEPRINT Permit b /L 630
Please . • sections, . . Number - ---____l--_. Date
1. Location of ins allation 4. Complete Fee Schedule below
Address jt r+ X--% , ► __ Number of Inspections per permit allowed
,� uildinn
City Service Included: Items Cost ea. Sum
t !�- n�a�_-i `'"�. Suite No.----------- Cost(ell
Tenant Name A. Residential-pgr unit
(if commercial)
`- - -- 1000 sq ft.or less -__---_ $110.00 ---_-__-_-
n
Map No.R-200.3&L• Z Tax Lot tSC 3- t3Fso, Each additional soo sq.ft
or portion thereof - --- $25.00 ---------
!,r r(- Limitsd Energy -_ $25.00 1
Thomas Ma Book: Page:�, _� / Section;�/ -
Each Manurd Home or Modular
Directions_;A,u, .t��F1�e�� 3, 3' <,
., ' rte -` Dwelling Service or Feeder - _ . _ $66.00 __
2----- —--
Commercial Residential B. Services or Feeders
Installation,alterations or relrx;atlon
200 amps or less - $6000 ----------- 2
2a. Contractor installation only: { 201 amps to 400 amps - _ $8000 __ _ _ 2
Electrical Contractor t L, i 7 c t_ 04 401 amps to 600 amps $120.00 _ ._ _-__-- 2
Address S 4 35 SC-•� tom- l sot amps to pito amps -_ $18000 __- .__ 2
���'�- Over 1000 amps or volts S340 on _ 2
City -. I Aa State fes- ZIP._.2M2.:X Hec mnect only $50002
Date Job Num r _ ---- --
Property Owner' C. Temporary Services or Feeders
Contractor's License No. -344 - .70 Installation,alteration or reiocat)oo
Contractor's Board Reg. N 200 amps or less -- $50 00
201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n 401 amps to 600 amps __- $100.00 _-- 2
License No.3' one No.Jr�'y 'L/ I Over 600 amps to 1000 vo;ts see"B"above
FAX No. D. Branch Circuits I
New,alteratior or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or feeder fee.
Print nets ame Phone leo- Each branch circuit _ $5 oo
_ b) The fee for branch circuits wlthm,t
mss purchase of service or feeder fee.
_ _ First branch circuit $:f5 oe
state —� Each add'nl branch circuit $5.00 2
E. Miscellaneous(Service or Feeder not included)
The installition is ryeing made on property I own Each pump or Irrigation circle $4000 2
which ic; not intendEd for sale, lease or rent Each sign or outline lighting S40 00 __
Signal circuit(s)or a limited
Owner's Signature - _ energy panel,afteration
or extension -_ $40 00 _-_-y 2
3. Plan Review section (if required) F. Each additional inspection over the allowable
i Plense check appropriate Item and entur fee In section 5B. In any of the above
___4 or more residential units in onr- s;ructtlre Per mrpertion $3500
Service and feeder, 800 amps P,,r I'n"r $55 00
---- p or more 00-- —
System over 600 volts nominal In Plant $55.
----
__Classified area or structure containing special 5. Fees
occupancy as describwll 'n N.E.C. Chapter 5
Submit 2 sets of plans with applkatlnn where any of the above A. Enter total of above fees $
/� S -.—
apply. Not required for temporary construction ,iervices. 5 urcharge ( 05 X totai fees) $
Subtotal $
This permit becomes null and vold If the work authorized by the permit Is not 19. Enter 2F,"c, of line A for
commenced within 190 days from ditto of Issuance of such permit or if the Plan Review if required (Section 3) $
work srthorized Is suspended or abandoned at any time after work Is Subtotal $ Y
commenced;or a period rd 190 days Electrical Permlto are non-refundable Subtotal
and non-tranaMrable F1 Trust Account
For Inspections call Balance Due $`
681-3699 or 681-3698 -----
24-hour recorder, one working day In advance of need
BL28 - 6/95
DEPARTMENT OF LAND USE 8 TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST. HILLSBORO,OR 97124
a a;_;;^Ls, - COUNTY, INSPECTION REQUESTS: 503/F40-3561/693-4415
OREGON batF-1 0
,.
i'imr 1.7 : 36
�r171i COMBO Permit # 05081260
APPROVED Applied 1)5/24/:1996
.D i to A�:lcaress 161.10 SW KEE:RINS CT TI Issued 1U/07,/1996
FR - 4 b 3 BA ATT GAR 1: ('ompietecl
KERRON ' S CREST 2 , OT 71 To Expire 03/31/1997
r ) iec•t # P01J59333 Ve. luation : $163 , 076 . 0o
F-�rcNl Nun;ber 2S1 05U0 02301
;:C-c_Ictl. ACRES 6 . 32 , I iiVe;C,NED FARML.bND-POTLN'T IAI:, ADDITIONAL, TAX !
I
rwner P C DEVELOPMENT INC Construction NEW
Name : RUC'KWELL:-BRo1JGH'T'UN INC �_ J.a^c;al. xcat:i�n 101 4
Ari-plicant Addr . P.O. BOX 757 Occupancy R3
Hi:':
unif ied
sewer-age SANITARY*
agency
Uf155 N. First Ave., Suite 270, Hillsboro, Or.,97124 SURFACE WATER
503 648-8621
C 0 N N f-CT T n N Pf N 1`1 T T
11 1.002 9 6 F_X P C R 1) F TO N Vl AfT. 0'.3:'31,? I"r, r.XP DAIT t00290 V'l.:'RIiTT 1. 1 I.
AT.'11ICTURE AE1rjRFS9 :16910 PROJEC1 kti(75
TAR11CMIRIF 9TRFJ'7'.T 514 KFF'Rl`N!3 fJ
L(I'l 71 DL OCK
i Ypr r(INpjrr,'( Ti')N - f,jFW OF M71iROW3 lAZF.'1'T PHASE 11
TYN TNSTALLA7'T0N-- ( 19) R1,171
TYPE" OrCITONU."( I. FAM rLY PARCEL 5 t'B 1.3800
(:)TR SIT IAJl fill
OWNER ROCKWFIJ -ORMIWIDAY
ADDRESS PO t-(O"' 7,.'17 T[',,I A I fil. N 1 1:11 A141 MINI-11"IM
SHF*RIjouri OR 9Y 1.40
r'HONF 625-061`15 WAI 1 (11 11 1 '.i I I;1 1 1 '1 F."o;'Z El
F*TXTURE EQUIVAI IJI1 DWFI I TMfi PI AL
IINI.TS 11 11N I 1*!3 0. 0 11N 1 '3 1 !,;1 RV r.I. F (IN I'f
CONNFC T1 l"IN FT FS 5111,'l hi'll' 10)1 l P lit VI I M-111 N I I I I S
rrIJFR CONNIA"I VIM 0 00 WA IFR 01,161, 111A 100. 00
LEM,; 17111FID111, 1 1710, 00:
wArv'r< oijAm'rV'T'e 100. 00
F R D' r 0 14 (A)N I'R 0 L.
T N 1,1' f''I"I i'l 14 64 , 00
I"I AM `I I; CK I
(i I I 1:t T I I I'A L 2i?00 00 '311-' f 0 TA L
TOI Al
N A i.11 1 1111114 F"I ION I"
l L.L.I AI I Q N (I W N E R
REMARKS PROJ 41 65. 1 n'T 1 51 .1 1
, '1 H 0 11 P N 11 T I I",V. FOR FR 0!'; 11)H I I (R I I I T N 5 I'f:("I 1'nN3 R F'()IJ I PE D
+4*** Wimbe r r i- 11 1114 P444!414 A'***t*
S1210111RA I.TMIJI By GROW"Sh
Pereilt Co ons. rhe applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. Vviien cal; q for an inspection, please
refer to tho Permit Number. The Permit expires one hundred eighty (180) days from the date of issuance. The Agency does not guarantee the iccuracy
of the location of side sewer laterals.
7/93 WHITE USA, BLUE Accounting, GREEN -inspection, YELLOW Customer
WASHINGTON COUNTY
DEPARTMENT OF LAND USE AND TRANSPORTATION —
f�\ LAND DEVELOPMENT SERVICES DIVISION Building Permit No.
155 NORTH FIRST AVENUE
HILLSBORO,OREGON 97124 648-8761
COUNTYWIDE
+
C O O N TYW I D E Planning File No.
TRAFFIC IMPACT FEE
RJPAYM E NT OPTION FORM Tax Map & Lot No.
�T
Date
V,--kez�')S
Project oject Name
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I
request the following (Choose Wlichever option or options are applicable):
x Cash or Check
t�.J
Credit Voucher
CBancroft or Installment Payments
and/or
I_
The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit
if the TIF is greater than $5,000.00. If the TIF meets this requirement, I also request this option.
I understand the TIF must be paid prior to issuance of an occupancy permit. I also understand
that the TIF will be recalculated based on the prevailing rates G. me of payment. Please be
advised that TIF rates may inrrm.ase up to six percent each July ;t. This rate increase is not
subject to appe.-J.
OWNER/APPLICANT 0-1 , cR/APPLICANT
CC Building Permit File
Pei,ment Option Notebook form tif02: 8192
DEPARTMENT OF LAND USE.&TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION
WASHINGTON'
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON Facto 1 of: 1
Date 05/24/96
Time 15 : 31.
P,2rmit TYPe e.,vmoination Bui 1.dlnc4 Permit P—, rmit # 05081-:1-10
N.rrnit StattJ� PENDING Issued ':.x/24/46 i
�-'itu.s Address 1621U SW KEE?R114S `.I. T1 I �Sueci
i', rinit Tit ie SFR - 4 BD 3 BA ATT GAR LV Completed
p,=,1-mit Desscr . KERRON ' S CREST 2 ;.,f:).,, '71 To Expire
Pro 'lect Titie : SFR - 4 BU 3 BA ATT GAR LV' Project # P005S33.
t,ro-ject Descr .. KERROW S CREST 2 LOT 71
Parcel. Num.., r 2S1050u-02301 Landt_):;p C>iRst:..r:irMED
_t
Valuation 190 , 0()0
I,e qa.L Descr .. : ACRES 6 . 32 , UNZONED FARMLAND-POTENTIAL ADDITIONAL TAX NEW
owner ; P C DEVELOPMENT INC'. CiasConstruction
101
Applicant. Name ROC:'KWE 1,L-BROUGHTON INC. Occuri t .l rat s on R 3
Applicant Addr . P .O. BOX 757 Occur,ancy R3
SHE.RWOOD OR 97140 VaIir1ateci by : CEI
Applicant Phone! 625-0685 Inspector Ar.eA
Met-hod Check # Receipt No . Date Payment i
CK 357 75/24/95 427 . '70
TO'.i'AL, THIS DA'Z'E +:* * k** *** 427 . 70
{
NOTICE This permit becomes null and void If the work or construction for nhlch It Is Issued Is not commenced within 180 days Once constructionlias ed
the permit becomes null and void If cons'ruc Jon Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Deportment's reliance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws end ordinances governing the construction and use
of this building or structure will be complied with whether or not speLined on the plans or noted on the pians correction sheets, I acknowledge that
th-granting of a permit does not grAnt authority In access private property or to use easements. I further acknowledge that the use or occupancy of
tt+e structure or building permitted depends upon my calling for Inspections at various times during the proces+e of construction and the building
inspection staff verifying compliance with the various codes Use or occupancy of the building or structure permitted prior to approval by the
Building Derartmant Is 3oiely at the risk of the applicant and such use or occupancy Is revocable until all Irspectlon requirements are satisfied and
approval is r Ivan by the Building Official I further acknowledge that a lien may be olaced on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable u+ti +e satisfaction of all Inspection requirements.
I�PUCANT'S SIONATURF.
s
k J%
h
1
le-
.��p'�.� � I��i,V M.'[1t'Ml1 �/l�,�I�..�y �„�-�+� 'Ci�I1►M.�
IT
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Alf�
GA!� _.�._.._ f 'l �•, -
!L);: '
►� RD �_.�- F r if NO .9 rti,
� r; _ ,'AL W/0 APPROVAL
FT
REAR Ylaf7Lb _/ � P i.ANT�rn�E:
APPHOVCO,''1'. r1r=r,0�'AL
DEPARTMENT OF LAND USE 81 TRANSPORTATION
OA014%tWASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124
OREGON PHONE: 503/640-3470
INSPECTION REQUESTS(24 hours): 503/681-3699 or 681-3697
11ru jec:t # P00b9333 'Status: APPROVED PAGE 1
ryN�r ipc, f%SULd : 10. 02( IY96 L:xpires- 03/31/1997 01/28/97 06 QC)
npoill''ri Hype. Conrtructic,n T-./pe: NEW
t- 1tI.e S1.R' 4 BD "3 ISA ATT GAR. LV
on 2 LOT 71 0e9un: 0:5/2..r4/1996
N,;t ,..�•Ss; 1r:,E1O 'aW K£'EIl:l'NS CT Ti
l,_,o c a t i.o n
a'k :wurc 011� 1,a'il. . Regi.on
t" CC' f7.EVfI.r:.3t11ENT J.N(, Phnr,c�:
sal, r, r,:r-trrt r,I, Ytle NC1(;KWELI -LIkrJU H"TON INC• Phone: 625-0685
t;a1-1t -cctf.)r: P1`:iC,t(WI't t_. 6RIJUGHTf.1N, INC Phone: 625--0685
P.,r i n I
AppilPf'! Approved
7r�Hf� F,rhl i'riiTfl114 nt�- Re jeCtedY — _.
�-
....r......_. r._.:r.k...- .� h 1 VR--RESULT'S
REOUEST ERROR I
tell 0 fate
Acl: i.or, ! c c r � {_a r_;rY RegUest0T' Ar,e
.t
f1P f f)N 1
ts: Requeste ru IVR "1l
t-tlO
L oV re 3>
AP DN I vl-1
p13 Action. AF'F'R IVR ; — JI)spection
AP VN Ik
Action APPR IVRS -- I'nypection
rl�= k t rti AP DN
R13 Action Af'}:p IVRS Inspection
I
DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124
PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503io81-3699 or 681-3697
05081k60 z ,: i ,r,";'a— �_' .3
p l'if?'C.a. yf'";at.J 10P.
ti(, ,' fk'],{�./1 Ty}36� .�ti✓fi1'i•., l`.a�i!�:.t_y :,r'1 clT'r Ni
T.itI S,FR 4 r-,r, ,. ki'. Al''A' GA I. .
A.idx tisac 16210 :W XFW;ClNf+ CT 'T'I
.Y,��,�r Ns���".: k' ,.. ��"v'1�i,�::Z�N1;"N'a IHC• .
Naxsip•
I N:.
Comments
l./
:•� �pY i T1 1.1 Y tt� tY iit
DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
155 NORTH FIRST, HILLSBURO,OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECT,'ON REQUESTS(24 hours): 503/681-3599 or 681-3697
tS 0G08, e ,
1 f 2 1 !'. tiW K E k: ;11v S ('T 7'!
F` ii L,a r :r Lxr,a� 4 13aa:r
DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
COUNTY, 155 NORTH FIRST, HILLSBORO,OR 97124
OREGON PHONE: 503/640-3470
INSPECTION REQUESTS (24 hours): 503/681-3699 or 681-3697
7tatus : APPROVED PAGE i.
031.31/199 11, 128/96 06: 00
!;oristr,uct-ion I v p e NEW
ti. .., 1 13tq!.krY: di'�F/1, �'ra£�
Y fF. I �.
f?esti. � nra
_.__. __.._....._.__,_... .��... .._..__,. T V _...Rr S0L
rl
-..__._.. .. .._... .__..__ ...,..._._ �...__ ._ REOOE ST ERROR !
DEPARTMENT OF LAND USE R_'rRANSPORTATION
WASHINGTOPI LAND DEVELOPMENT SERVICES DIVISION#350-12
a Its,^, — 155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUES"3(24 hours): 503/681-3699 or 681-3697
h'r• t4: c s. r# �'t)U ) r q.5. rt.1t.Ui, HF'I"t�11'Jf:.11 ('fdk;L 1
0.3/31/ 19'•"r`7 11 /07/96 06. 00
i--OnstructiLin TVpe: 11FW
iA 4'( 1 ;AFS L
Deg un,. 05/24/1994)
Ad f' Sh1
wtoi.on
p 0nv'
prat 14„l;nF r t;,, til.: t. 1lR 0.”':H I"N I:+1 Phone: 62.."9- ,. 685
Phone
1
1
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