10507 SW NAEVE STREET IS 3A3VN MS LOSOI
CITY OFTIGARD MASTER PERMIT
PERMIT 9: MST2000-00566
DEVELOPMENT SERVICES DATE ISSUED: 1/5/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171
SITE ADDRESS: 10507 SW NAEVE ST PARCE'_. 2S110DA-06100
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT:022 JURISDICTION: TIG
REMARKS: Construction of new single family detached residence. Path 1.
BUILDING
AR
REISSUE: STORIkB: 2 _ FLOOR EAS __ _ REQUIRUD SETBACKS w REQUIRED
CLASS OF WORK: NEW HEIGHT 24 FIRST: 1.843 of BASEMENT: d LEFT: 7 SMOKE DETECTORS: Y
TYPE OF USE: Sr r'LOOP.LOAD: 40 SECOND: 1.e94 of GARAGE: 711 of FRONT: 23 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: of RIGHT: 7
VALUE ?;299.198 un
OCCUPANCY GRP: R3 SDRM: 4 BATH: 3 TOTAL: 3,137 00 of REAP.: 88
_ PLUMBING _
SINKS: WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINFS: 100 SF RAIN DRPJNS: 1 CATCH BASINS:
TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATFRS: 1 WATER LINES: 100 BCKFLW PREVNTR. 1 GREASE TRAPS:
OTHER FIXTURES:
I MECHANICAL
FUEL TYPES FURN<tOOK: OCIUCMP<THP: V'F.NT FANS: 15 CLOTHES OR fER: 1
GAS FURN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: OAS OUTLETR: 1
ELECTRICAL
_ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp: 0 200 amp: WfSVC On FDR: 1 PUMPIIRRIGATION: PER I11?r2CTION:
EA ADO'L SOOSF: 9 201 400 amp: 201 400 amp: Id W/O SVCr;DR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 800 amp: 401 400 amp: EA ADDL BR CIR: SIONAUPANEL- IN PLANT:
MANU 1MISVCIFDR: 601 - 1000 amp: /ot.ampa-10oft MINOR LABEL:
1000•ampNott
PLAN REVIEW SECTION
Reconnect only:
>R4 RES UNITS: SVCfFDR>•223 A.: >$00 V NCMINAL: CLS AREAISPC OCC:
ELECTRICAL.RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO R STEREO: VACUUM SYSTEM: AUDIO d STEREO: FIRF.ALARM: INTERCOMMAGING: OUTDOOR LNDSC LT'.
BURGLAR ALARPA: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTFCTIVF SIGNI:
GAnAC?:OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HV<.C: DATA/TELE COMM: NURSC CALLS: TOTAL N SYSTEMS:
Contractor: TOTAL FEES: $ 7,376.11
Owner: This permit is subject to the regulations contained in the
W RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal C^de,State of OR. Specialty Codes and
167?SIN WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR eA other applicabieJ idw•s. All work will be done in
W WEST LINN,OR 97068 WEST LINN,OR 97068 accordance with approved plans. This permit will expire H
CL work is not started within 180 days of Issuance,or if the
work is suspended for more than 180 days. ATTENTION:
HPhone: Phone: Oregon law requires you to follow rules adopted by the
3 y Oregon Utility Notification Center. Those rules are set
Rea A: LIC 049955 forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
rp mOUNC by caning(503)2413-1987.
REQUIRED
W
W Erosion Control Insp 8, Post/Beam MechanicalMechanical Insp Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor Insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing Insp Crav'Drain/Backwater Plumb Top Out Exterior Sheathing Incl Rain drain Insp Plumb Final
Foundation Insp Footing/Foundation Dr; Electrical Sorvice Low Voltage Water Line Insp Final Inspection
Post/Beam Structural FLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwik Insp Building Final
Issued By : Permittee Signature
10507 SW NAM ST Call (503 639-4175 by 7:00 p.m.for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2000-00387
42 1.31M 13125 SW Nall Blvd.,Tigard, OR 97213 (503)639-4171 DATE ISSUED: 115/01
SITE ADDRESS; 10507 SW NAEVE ST PARCEL: 2S110DA-06100
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK LOT: 02.2 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS 0� _ARK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF P_UILDINGS: 1
INST \LL TYPE: LTPSWR IMPERV SURFACE:
?emarks: Sewer connection permit for new single family residence.
Owner: FEES
RENAISSANCE CUSTOM HOMES — --
1672_ SW WILLAMETTE FALLS DR Type By Date Amount Receipt
WEST LINN, OR 97068 PRMT CTR 1/5/01 $2,300.00 27200100000
INSP CTR 1/5/01 $35.00 27200100000
Phone: 503-557-8000 Total $2,335.00
Contractor:
Phone:
Rag#.
Required Inspections
Sewer Inspection
a
a
U)
m
W This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
_j 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 located at the measurement given,the installer
shall prusnect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewef" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
Ycu may oMain copies of these rules or direct questions to Ol1NC by calling(503) -1987.
Issued by: `.Q- m Permittee Signature:
Call(503 sz9-4175 by 7:00 P.M.for an Inspection needed the next business day
r �� /
Building Permit Application
City of Tigard Date received:r�•/%00' Permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Prolect/appl.no.: Expiredate:
City nJTignrd
Phone: (503) 639-4171 Date issued: _ By: Receipt no.: N
Fax: (503) 598-1960 Case file no.: Payment type:
1&2 family:Simple Co ilex:
Land use approval: _--_ _ y" p "�
'1' &2 family dwelling,or accessory ❑Cimmercial/industri3l U Multi-family flew constnictinn 0 Demolition
❑Add ition/alteration/replacen tent J Tenant improvcnievt 0 Fine sprinkler/alarm ❑Other:
Job address: f iv_ T. Bldg.no.: Suite no.: _
1_ ivion _ xSubs : Tax map/tax lot/account no.:
Project name:
Description and location of work on premiscs/spccial conditions:
Name: MNA%*A. _HOME 5
Mailing addres:v QF 1 I< 2 family dwelling:
- r'
City:��l1 _ I St+tc: 7_IP: 1t>y Valuation of work................................... .... sD
Phonc: Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: Total number of floors................................. _
-- — —
Plwnc: - Fa E-mail: New dwelling stea(sq.ft.) .......................... _j f
11111111111111KI 111111 a talks Garage/carport area(sq. ft.).........................
Name: Covered porch area(sq.ft.) ........................
`-- Deck area(.aq.ft.
Mailing address: )........................................ ---
City: State: ZIP: Other structure arra(sq.ft.).................
Phone: _41Fax: E-mail: Commercial/industriadmulti-family:
Valuation of work........................................ $
Business name: Existing bldg.area(sq.ft.) ..........................
Address:
New bldg area(sq.ft.)................................ —
EcE Number of stories........................................
Fax:City: __::I:S2ta ZIP: Type of construction....................................Phone: mail:
- Occupancy group(s): Existing:
CCB no.: New:
City/metro lie.no.: Notice:All contractors and subcontractors are requited to be
licensed with the Oregon Construction Contractors Board under
Name: 0provisions of ORS 701 and may be required to be licensed in the
p Address: Q _ jurisdiction where work is being performed.If the applicant is
U: City: State: Z1P:
exempt from licensing,the following reason applies:
Contact person: SPOA Plan no.: _ -- ----�
Phone: �y Fax: mail:WlVk.W.- —� -
J
W Name: C6A I Contact person: elkRy Fees due upon application ........................... $ _
W Address: U-1 t� 4 Date received:
._.t City: pj State: ZIP: Amount received ................... . . . _
Phone: FatQ=r 'Q E-mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all Jurisdictiaa accept credit cards,pease call Jnrisdialon for more information.
attached checklist. All p sions of laws and ordinances governing this ❑visa QMasterCtud
work will be complied itl ethers cified herein or not. Credit card numb-r:__. =_ L1__
Authorized signature: Date: t�' '—I Va' Name of ca"Itmider of shown on credit card
S
Print name: —�� - �Catdhalder darrntae" - Amouat
Notice:This permit application expires if a permit is not obtained within 190 days after it has leen accepted as complete. X1613(6mcom)
Plumbing Permit Application
City Of Tigard
Date received: Permit no.:
Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
t'iryuj7'igrr`l Phone: (503) 639-4171 Project/appl.no.: _ Expiredawc
Fax: (.503) 598-1960 Dale issued: By: Receipt no.:
Land use approval: — Case rile no.: Payment type:
I &2 family dwelling or ac:essory t]Commercial/industrial U Multi-family U•renam improvement
ew construction U Addition/alleration/repiacernenl U Food service U Other:
Job address: P6 0 1 S Description Qty. F'ee(ea.) Total
Bldg.no.: Suite no. _ New I..ant;;-fnmUy dwellings only:
Tax map/Gut lot/account no.: '- (Includes l000.for eachutltityconnealon)
-- SFR(1)bath
Lot: _ Block: Subdivisions SFR(2)bath _
Project name1gr"IM4 SFR(3)bath
City/county: IP: Each additional badAitchen
thscriptionand lavation of work on premises: Siteutii: ledr:
"SAL& �INlwt IL.Y _�_ �� Catch basin/area drain
Est.date of completion/inspection: Drywells/leach line/trench drain
momd Footing drain(no.lin.ft.)
Manufactured home utilities
Business name: G {N Manholes
Address: 10 W W1 Rain drain connector
Oily_ State: ZIP: 411 Sanitary sewer(no.lin.ft.) ---
Phone:601114 AWOF444JAWE-mail: Storm sewer(no.lin.ft.)
CCB no.: Plumb.bus.reg.no:l.Q.. b Water service(no.lin.ft.) --
City/metro tic.no.: _ Fixture or Nem:
Contractors representative signatore: - Abso tion valve
Print name: -z - Back How preventer
Date: Backwater valve
Basins/lavatory
7Add,ess-.:?F
EN�' Clothes washer
- Dishwasher-- Drinking fountains)
_ State: 71P: Ejectors/sum
Phone: Fax: E-mail: Expansion tank
Fixture sewer cap
Name(print):�rN Floor drains/floor sinks/hub
Mailing address:
Garbage disposal
:, W Hese bibb i
City: State: ZIP: /1'1Q Ice maker
t1 Phare: Fa E-mail Intetre !or/grease trap
It Owner installation/residential maintenance only: The actual installation Primer(s)
t- will be made by me 054c.maintenance and repair made by my regular Roof drain(commercial)
employee on die proown as per ORS Chapter 447. Sink(s),bmin(s),lays(s)
Owner's signature: Date: ��• �9 Iib
J Tubs/shower/shower pan -
Name: Urinal
WAddress: 1 a�{qf ---- Water closet
Water heater
City: Stale: ZIP: 0 Outer: -
Phon IF, E-mail: Total
Not all jurisdictions accept credit cards.please can jurisdiction for mat Inrontimlon. Minimum fee................$
—
Notice:This permit application -- --
U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credit card number:.-_ __._,.______ F,pI / within 190 days after it has been State surcharge(8%)....$ _
-- — accepted as complete. TOTAL .......................S
Name d cardholder as shown on credit ce-d p P ----------
_ t
Cerdhotder signature Atrtouni aWl-a!,IF(&WWOM)
ELEAMSSMF'LETE:
FIXTURES (Individual) Qty Ptice. Total
Sink t8.fi0 Flrlure Typa _arc f o�nNa�_
L..vatory -- 16.60 Sink - Now ]-Rlmd
q ( wean
_--- � -'-—
Tub or Tub/S 1-avNory
hoover Comb. _ 16.60 _ Tub or Tub/Shower Combination - -
Shower Only 16.60 Showe,Only _ --
Water Closet1660 Wete'r Closet --
__ _Urinal -
Urinal 16.60 Dishwasher --
Dishwasher 16.60 Garbage Disposal --
G - LaundryRoom Tray—
Garbage Disposal - y
16.60 Washing Machine
Floor Drain/Flnor Sink 2'i
Laundry Tray 16.80 � r
T
Washing Machine — 16.60 -_ _4"
Flnrn Drairi/Floor Sink 2 16.60 Water Heater - - -"-
3 16.50 Ot urea
4' 16.60
Water Heater O conversion O like kind 16.60 —
Gas piping requires a searale echanical pemiil. _
MFG Home New Wale(Service - 46.40- -
_ -.
MFG Home New San/Slorm"1
46.40 + ` ^ ♦ h.
Comm EN1iir 611WNO ABOVE: j
Hose Sibs 16.60 • '61
Roof Drains 16.60 _ ♦ .�l,� __�
illy q
Drinking Fountain - 16.60
Other Fixtures(Specify) - 21.75
�VP
Tt t T 'fes--
_
Sewer-1st 100'` 55.00 •�'S�_ y 1 ����� , � ' ••
Sewer-each additional 100' 46.40 4o,
Water Service-1st 100' F5.00 �ej '�•; J�J+"
Water Service-each additional 200' 40.40
Storm&Rain Drat,-1 st 100' 55.00
Storm 6 Rain Drain-each additional 100' 46.40
C)mmerdal Back Flow Prevention Device - 46.40
Residential Backflriw Prevention Device' 7.55
Catch Basin 1 60
Insp.of Existing Plumbing or Specially Req
ues
-inspections
Rain Drain,single family dwelling - 65.25
Grease Traps — 16.60
QUANT TOTAL - ♦��'r��:a,h•�1 ?•1
Isometric or rim diagram is reyuved I Qoj)n Total Is >a (! • ' �. ,W S
'SUBTOTAL r ^ 1',�J-1 f ��
�1 �uI.
r�.,r ` �r�j �'` •=, .1�, �r•� •��JO
EY
IL SURCHARGE `l?t e
� yet
H
**PLAN PEVIEW %OF SUBTOTAL.
Required only I fiftre .total >g 1
TOTAL �P �Z .a A
'Minimum permit fee Is S72 SO♦a%surcharge,exceo Reskbntlat BaeMow Preverom
tka4oe,whldx h$36.25♦e%narhiepe.
"AIL New Commerclal Bundings"oke pWns with isometric or rfw diagram and pian reviewLU
••►� t aar`r S�p�'.
*Ali 4L
X�
Mechanical Permit Application
-+ Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SIN Hall 131W.Tigard,OR 97223 Date issued) By: Receipt no.: —
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval — —_ Building pernlit no.:
7�1 & 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
1New construction U Addition/alteration/replaceinent U Other: __---
KIM M
Joh address: tVA301ff.__ Indicate equipment quantities in boxes below. Indicate thr,dollar
Bldg.no.: _— Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value
Lot; Block: _Subdivision: "See checklist for important application information and
jurisdiction's fee schedule for residential permit fee.
Project name:
City/county: I Zr•i'x._223
Description and location of work(,n prr rises:__—_
Fee(ea.) Total
Est.date of completion inspection: _ IlMteri " Qty
Res. Ret.only
Tenant improvement or change of use: Air handling unit _ CFM
Is existing space healed or conditioned?U Yes U No Aucon iuoning(site lanrequ - __ _.
Is existing space insulated?U Yes U No Alteration of existing HVAL,system
Z01r compressors
boiler permit no.:Business name: HP Tons—B7 U/HAddress: L Q srno a amper duct smoke electors _
State: 7.Ip: Z eat pump(site plan required)
_
City: S —. —._ —
Fax: E- il: Install/replacefurnace/burner
11 on*;A. �. niaIncluding ductwork/vent liner U Yes U No
CCB no.: nsta rep ac re.ocate heaters-suspended,
City/metro lic.no.: -_ wall,or floor mounted
Name(please print): ens orappliance of er than furnace
e Rerat on:
Absorption units BTU/H
Chillers __— lip
Name: f - Com iressors_ lip
Address: _ _ v ronrnenta ex utt an ventilation:
City: Stale: ZIP: Appliance vent _
Phone: Fax: E-mail: ryerex aunt
Hoods,Type /11 res. itche azmal
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mailing address: x aust s stem a an rom tea In or
AC
ue p p ng and disforibution up to 4 outlets)
d City: W (aState ZIP: d Type: LPC; —_ NC Oil
a phon Fa E-mail: Fuel pipingeach a auona over out ets
rocesapiping(schematic required)
U)
- - Number of outlets
Name: -fWr listed appliansce or equipment:
J Address: �, _�� Decorative fireplace
City: State: ZIP: nsert-ty
WPhon Email; cr stov pet et stove
-•t Applicant's signature: L7 Date: olh,,
Name (print): -- —
Permit fee.....................$
Not all jurisdictions accept credit cards,please call juris ictitm for rttore tnformatlon. P PP Notice:This ernit fl lication
Minimum fee................$
U Visa U MasterCard expires if a permit is not obtained
Credit card number: It - I-- Plan review(at _ %) $
Expiles within 180 days alter it has been
_ p State surcharge(8%)....$
Name of cardholder as shown on credit card $ accepted as complete.
TOTAL .......................$
Cardholder sianattue _ Amount 440-4617(6AWOM)
Electrical Permit Application
Datereceived: Permit no.:
City of Tigard Projsa/appl.no.: Expire date:
City of l'igard Address: 13125 SW Ilan Blvd,Tigard.OR 97223 Date issued: By: Receipt no.
Phone: (503) 639-4171
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: _
�ew&2 family dwelling or accr�.ory U Commercial/indusirial U Multi-family U Tenant improvement construction U Addikon/alteradon/replacemew U Other: —_— U Partial
Job address: k) AOil, Bldg.no.: Suite no.: Tax mapilax lot/account no.:
Lot: 22m 1 Block: Subdivision la ]5—_`
Project name: Description and location of work on premises: till
Estimeted date of completion/ins ction:
Job no: Re Mas
Business name: --�+� ce Description ea Total no.!np
- Nen residential-single or multl-famlly per
Address: dwelling wit.lncbdmattachedowage.
City:L Slate:, servicefoclrrtkrl:
Phone:6051• 04?, Fax 4" E-matt; lax)sq.ft.or less 4
CCB no.: Elec.buslie.no:
G' Each additional 500 sq.ft.or portion thereof
— Limited energy,residential 2
Cltyimelro IiC.no.: Umited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician re utred) Date Service andlor feeder 2
Sup,elect.name(pdnt): License no: r+ervlcesorfeeden-Intiallatlon, -
alt�rotlon or relocation:
200 am s or less 2
Name(punt): U401 201 amps to 400 amps Y 2
Mailing address: Z, am s to 600 amps _ 2
601 amps to 1000 amps 2
City: NStade: / ZIP: Over 1000 amps 4'r volts 2
Phos Fa L'-mall: Reamnectonl --__ _ --,- — 1-
Owner installation:The installation is being made on property I own Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,olteration,orrelocation:200 amps or less
ORS 447,45:,,479,670,701. ----I 2
201 amps to 400 amps 2
Own'u-'s si nature: Date: 401 to 600 amps 2
Ile inch circuits-ne+v,altenstlen,
or extension per panel:
Name: L _ _ A. Fee for branch circuits with purchase of
Address: NO SIV 4M service or feeder fee,each branch circuit 2
City: Stat tQ ZIP: L' � B. Fee for brooch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phon F ,� E-mail:
IL Each additional branch circuit:
Mise.(Service or feeder not Included):
F U Service over 225 amps-commercial U Health-care facility Fach pump or irrigation circle 2
N L
U Service over 320 amps-rating of 1&2 U Hazardous location Foch sign or outline lighting - 2
family dwellings O Building over 10,000 square fee(four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration,orextensinn' t 2
m U Building over three stories U Feeders,400 amps or more *Description:
5 U Occupant load over 99 persons U Manufactured structures or RV pre FAA additional inspection over the allowable In any of the above.
W
U EgressAightingplan U Other. r
— -- Pcrinspection -
Submit_sells of(~tats with any of Ilse above. Investigation fee
71st above are not applkabk to temporml construction service. Other --
Not all juridictions acce(x credit cads,please call juridicdom for coo information Notice:'his permit appllcalion Permit fee.....................a
U Visa U MasterCard expires if a permit is not obtained Plan review(at %) $
Credit cad number: —^ _L� within ISO days after it has been State surcharge(8%) ....$
F'p1et accepted as complete. TOTAL . $
Name or cardholder as shown on credit cad ������������������""
_ S
Cardholder signature Amour_ Un-WIS(601A.'0M
e
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N 89'45'10" E 139.01'
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Z -- 66.2' ---- •�— 20.0'
8 (n
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M33 �u ^ ,aa-cc
ie
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139.01' S 89'45'10" W
ea oa n: < N >
OoftPADA0"mA.PEima"
GOIi�T'E DANE!>!IN PU10E.
z N90UbR 4YWTAN 801L�AEPft
�fZ FWftl of ft
SCALE 1" a 20'
PuRv YO all.Pyla DRE
FOlA�M11�10 AlR1 PRc., `-""-""'
SLUIBOMMIXTOAMSI RVEY. STAKEOUT LOT 22 ERICKSON HEIGHTS
-� S.E. 1 4 SEC- 10 T.2S. R.1 W.. W.M. 10501 5A) NAEVE ST.
-- MOVE CLOSEST POINT ON HOUSE TO 20' IN FROM CITY OF 11GARD
-- A 2.5 FOOT LANDSCAPE EASEMENT PER CLIENT, 12/11 MSG. WASHINGTON COUNTY OREGON
SHALL EXIST ALONG ALL STREET FRONTAGE — ADDED NEW HOUSE (LOT 38) PER CLIENT, s _ SEPTEMBER 4 20
AND A 7.3 FOOT PUBLIC UTILITY EASEMENT 12/11/00 MSG. ' 00C n t.e r l i n C G n c e p t s Inc.
SHALL EXIST BEHIND THE LANDSCAPE EASEMENT DRAWN BY. MSG CHECKED BY: WGOIIJ
SCALE 1 s20 ACCOUNT 1 115 640 62nd Drive Gladstone, Oregon 57027
M:\MU\L22ERICK 303 650--0186 fox 503 650-0189
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2000-00566
Date Issued: 115!01
Parcel: 2S110DA-06100
Site Address: 10507 SW NAEVE ST
Subdivision: ERICKSON HEIGHTS
Block: Lot: 022
Jurisdiction- TIG
Zoning: R-3.5
Remarks: Construction of new single family detached residence. Path 1.
Your company has been indicated as 'he 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 Dept.
No plumbing inspections will be authorized until this completed form Is received
OWNER: PLUMBING CONTRACTOR:
RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC
1672 SW WILLAMETTE FALLS DR 7736 SW NIMBUS AVE
WEST LINN, OR 97068 BEAVERTON, OR 97008
Phone #: 503-557-8000 Phone #: 644-8698
Reg #: I_IC 79666
PI M 20-148PB
r
AN INK SIGNATURE IS REQUIRED ON THIS FORM
7
U X
p4iL
Signature o!Authorized Plumber ;
7,
If you have any questions, please call (503) 639-4171, ext. # 310
quR„
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GAGE ENTERPRISES INC
PO BOX 1429 1
CLACKAMAS, OR 97015-1429
Electrical Signature Form
Permit #: MST2000-00566
Date Issued: 115101
Parcel: 2S110DA-06100
Site Address: 10507 SW NAEVE ST
Subdivision: ERICKSON HEIGHTS
Block: Lot: 022
Jurisdiction: TIG
Zoning: R-3.5
Remarks: Construction of new single family detached realdence. Path 1.
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
appropriate individual from your company sign below and return this Electrical Signature Form pror to the
start of the work to the address above, ATTN: Building Dept.
No electrical Inspections will be authorized until this completed form is received
OWNER: ELECTRICAL. CONTRACTOR:
RENAISSANCE CUSTOM HOMES GAGE ENTERPRISES INr
1672 SW WILLAMETTE FALLS DR PO BOX 1429
WEST LINN, OR 97068 CLACKAMAS, OR 97016-1429
Phone #: 503-557-8000 Phone #: 503-657-0142
Req #: su" 8188
LIC 34544
ELE 3-129C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X ��,a --- ` ,
Signature of Supervisi g iectrician
If you have any questions, please call (503) 639-4171, ext. # 310
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1. CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00346
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 08/15/2001
SITE ADDRESS: 10507 SW NAEVE ST PARCEL: 2S110DA-06100
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT: 022 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PRF,VNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS. TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIcS: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Irrigation backflow prevention device.
Owner: FEES —'-
Type By Date Amount Receipt
RENAISSANCE CUSTOM HOMES PRMT CTR 08/15.2001 $36.25 27200100000
1672 SW WILLAMETTE FALLS DR 5PCT CTR 08/15/2001 $2.90 27200100000
WEST LINN, OR 97068 --
Total $39.15
Phone 1: 503-557-8000
Contractor:
MOODY ENTERPRISES INC
PO BOX 713
ESTACADA,OR 97023 REQUIRED INSPECTIONS
Phone 1: 503-630.5532 Final Inspection
Reg#: LIC 5573
PLM 1171
a
o�
J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
m Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
W This permit will expire if work is not started within 180 dF ys of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law raqu;rPs you to follow rules adopted by the Or6gon Utility
Notification Center. Those rules are set forth AR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rule: or direct questions to OUNC by calling (503) 246-1987.
Issued By: Permittee Signature: t
Call(503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day
I.
Plumbing Permit Application
Daterctxived: cP 2 iJ Pcrnutno.:�t � p, 'O.�f/
City of Tigard
Address: 13125 SW liall Blvd.Tigard,OR 97223 Sewer permit no.: Bullding permit no.:
CUvoJ7Yga.d phone: (503) 639-4171 Project/appl.no.: Expire date
Fax: (503) 599-W60 Date iseued: By' Receipt no.:
Land use approval: _ _ Caere file no. payment type:
O�& 2 family dwelling or accessory O Commercial/industrial O Multi-family O Tenant improvement
ew construction O Addiuon/alteration/rrplacement O Food service O Other:
Job address: /0 V7 S , /Ver r'vc S' , . Fee eta. Total
1 �__
Bldg.no.: _ Suite no.: -a tp only:
Tax map/tax lot/account no.: (lucludN 100 It.LIsr"Asiftrcortneetlon)
Lor. �'7 Block: Subdivision: -- --- SFR(1)bath i
Project name:_ 'Z t Sa ti- e,6& i: SFR,. O bath —'
City/count _.___tj j I ZJP: 2 7 Z 2 T Eacha -n-0 at tc en —�
Description and location of work on premises: _57 .,, 4V&/�_ Slfsatllklast
Catch basin/area drain
Est.date of completion/inspection: wet eac Lne/troncnru n — —�
boting drain(no.lin. t.)
Maip-ractumd home utilities
Business name: •, ' �N �'t / J!f TA.... o es
Address:Fc' / _r drain connector
slat C',f111 ZIP: 9 7C 2.3 Sanitarysewer(no,lip. .)
Phone: "v1 3c �xpi
E-mail form sewer(no. n. .)
CCB no.;/17 7 umh.bus.reg.no: S' 'y mater service no.
Cit /metro lic.no.: Fixture or Item:
Contractor's representative si ature: soon valve
Print name: /; .A e,'?� nate: �/ , ick ow venter
water valve
n nvat0
Name: s wu
. ve .���=1 --- - er .—
Address: Pe' Sir 7/, t — to was lTc _
City: c StatelC/2 ZIP: J n n fountain(iii)
Ejector"UMP
Phone:fe 3,-C re. SrFax: ir,,jcr E-mail: Expansion tank
ix_tute/sewer cera
Name(print)! �twr&URi oor sinks/hub
Mailirtg address: — dis sal
Hose bibb
City: _4 State. ZIP: T m er
IL Phone Fax: E-mail:' _11110MOPtOrfiMBAC tra
Owner installation/residential maintenance only: The actual inetwiation Prmer(s
will be made by men a 'ntenance and repair made by my regular oo n(commercial)
employee on the p I as per ORS ter 447. a s�astn(s), ays s
Owner's si nat?tre: Date:
TublAhower/showerpaan
M Name: TRR
WAddress:
_I Cit star Water closet
_
Y: State: ZIP: Zkhcr.
Phone: T�—'Fax: E-mail: _ otrt
Na an iartut{erlone KC pr cn dtr cardr,plena cell iurW&Vdon for mon Wonwlan. Notice:Thi'1 permit xMilestion Minimum fee................$
o"111 1,MaeierCard expires if a permit is not obtained Pl-r.review(at , %) $
cno cant eumter:_ — �_ within 180 days after it has been State surcharge(8%)....S 3
I�" Naree�or u shown on c ter a Pted as complete.Iste. TOTAL .......................
: A4ount ap.Ibie(sAWCOM)
n� ELECTRICAL PERMIT-
C ITS( OF TI 'ARD RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT 0: ELR2001-00062
13125 SW Hall Blvd..Tinard,OR 97223 (50:;;639-4171 DATE ISSUED: 3/15/01
SITE ADDRESS: 10507 SW NAEVE ST PARCEL: 2S110DA-06100
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: LOT: 022 JURISDICTION: TIG
Prolect Description:All encompassing low voltage permit.
A.RESIDENTIAL _ B.COMMERCIAL
AUDIO&STEREO: AUDIO&STEREO: INTERCOM &PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTLoOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
10 L#OF SYSTEMS.
Owner: Contractor:
RENAISSANCE CUSTOM HOMES GREENLINE INC
1672 SW WILLAMETTE FALLS DR PO BOX 230755
WEST LINN, OR 97068 TIGARD, OR 97223
Phone: 503-557-8000 Phone: 968-1978
Reg N: LIC 103033
ELE 34-397CL
FEES Required Inspections
Type By Date Amount Rbcelpt Low Voltage Inspection
PRMT CTR 3/15101 $75.00 2720010000 Elect'I Final
5PCT CTR 3!15/01 $6.00 2720010000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
p, requires you to-fQllow, rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 %1-0010 thro-Ogh OAR 952-091-080. You may obtain copies of these rules or.d�rect questions to OUNC at(503)
N 24 -1987.
Is$ lad by ! , Permittee Signature
J - /
OWNER INSTALLATION ONLY
W The Installation is being made on property I own which Is not Intended for sale, lease,or rent.
W
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:!
LICENSE NO:
Call 639-4175 by 7:00 P.M.for an Inapectlon needed the next business day
Electrical Permit Application
[t'ef'ct/appl.
xeived: o/ Fefrmh no_:
City of Tigard no.: - Expiredate:
City ofTigarrf Address: 13125 SW Hall Blvd,Tigard.OR 97223 Date issued Y By: Receip,no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case filen.: Payment type:
.and use approval:
U I &2 family dwelling or accessory U Commercial/induslfiai U Multi-family U Tenant improveme it
U New construction U Add ition/a I teration/repl acement U Other: U Partial
lob address: �� Bldg.FoISuite no.: ITax.map/tax lot/account no.:
Lot: Vjo Llock: Subdivision: _
Project name: —�Description and location of work on premises:
Estimated date of completion/inspection:
,lob no: 11- Max
l
Business name: Descriptio fa< ToW las
New real I I -algt a err mdd-bo*Rr
Address: 1 dwealagurk 1wlodeadbclredWN
City: State: ZIP. l serdee, " ' '
Phone: Fax:W- - E-mail: 1000 aq.n.or Irsa 4
Each additional 500 sq.ft.or portion thereof
CCB rat Elec.bus.lie.no: dawLimited energy,residential 2
Oily/metro lic.no.: Limited energy,non-residential AY&A&je 2
F.ach manufactured home or modular dwelling
Si nature of supervising electrician(required) Date _ Service and/or feeder 2
Sup.elect.name(print): License no.. Servlceaorfer�en—hr1alMlMa,
alleraflwt nr relocatltrr:
200 or less 2
Name(print): 201 am
to 400 ps 2
401 arms to 600 amps _—
Mailing address: --`--_-__- 601 amps to IOOOmnpa 2
City. State: LIP: OverIo110ampsorvolts 2
Phone: Fax: E-mail! Reconnect only I
Owner installation:The installation is being made on property I own Temporwyaar0f kede'
which is not intended for sale,lease,rent,or exchange according to liast'IIxtion,aNeratlast, rel°e'tio.'
200 amps or less 1
ORS 447,455,479,670,701. 201 amps to 400 amps 2
Owner's si nature: Date: A 401 to 600 amps 2
Brooch dnwka-new,akerstloa,
or extemton per prrael:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder foe,each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
0. of service or feeder fee,fart branch circuit: 1
R Phone: Fax: E-mail: Each additional branch circuit:
Mise.(9eniee or feeder aM t w*Ad):
U Service over 225amps-commercial U Health-care facility
Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
J family dwellings U Building over 10.000 square fed four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration,of extension* — 2
U Building over three stories U Feeders,400 amps or more *Description:_
W U Occupant load over 99 persons U Manufactured structures or RV park Each a/dklorsal Itnspertim owr the agmraMe M say of gW nitam
J U Egresa/lightingplan U Other. — Perins�ectlou -- =T-
ftlassll^sets of pion with stay of the above. Investigation fee
The above are not apjpllcaMe to tmporsry constnKMoto wivlce. Other — —
New all)urisdlceerr accept credit eras,*me call)uritt iction fcr man•lnfamwton. Notice:This permit application
Permit fee.....................$ -- --
O visa U MasterCard expires if a permit is not obtained Plan review(at — %)
Credit cord number: within 180 days afler it hes been State surcharge(8%)....$ _
accepted as complete. TOTAL .......................$ --
Nrrre�Ider as an credit card eapires
Cardholder elgaaare
Assam 4404615(6AM)OM)
Electrical Permit Fees: Limited Energy Fees:
Complete a Schedule Below: TYPE OF WORK INV LVED-RESIDENTIAL ONLY
ResMcted Energy Foe......
................................�..-- $78.00
Humber of Ins actors er permit allowed (FOR ALL SYSTEMS)
Service Includ Items Cost Total Check Type of Work Inv
Residential-per unit
1000 sq.R.or less $145.15 — 4 Audio and S reo Systems
Esch additional 500 sq.ft.
portion thereof $33.40 _— 1 Burglar AI
Limited Energy $75.00
Each Manurd Horne or Modula Garage OfAner'
Dwelling Service or Feeder $90.90 2
Services or Feeders Hea g,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 V tun Systems"
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 smps to 1000 amps — $240.60 2 ❑ that._ T_over 1000 amps or volts $454.65 2
Reconnect only 586.85 _ 2
Temporary Services or Feeders ! TY OF WORK INVOLVED-COMMERCIAL ONLY
F for eachsystem.......................................................... $75.00
Installation,alteration,or relocation
200 amps or less _ .85 _ 2 (SEE OAR 918-260-260)
201 amps to 400 amps $1 30 2 "
4M amps to 600 amps $133. 2 Check Type of Work Involved:
-600 amps to 1000 volts, 0
soe'•b"above. Audio and Stereo Systems 1�1�a J1"
Branch Circuits Beller Controls
New,alteration or extension per panel `
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $665 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purrhase of service ❑ Fire Alarm Installation
or hada►fee.
First branch circuit $46.85 ❑ HVAC
Fach additional branch circuit $6.65
Miscellaneous — ❑ Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.4
Signal circult(s)or a limited energy ❑ ndacape Irrigation(,dxhfrol'
panel,alteration or extension $7 .00
Minor Labels(10) $ 5.00_ ❑
Med I
Each additional Inspection over
the allowable In any of the above ❑ Nurse Call
Per Inspection $62.50----
Per hour $62.50
In Plant _ $73.75 ❑ Outdoor Landsca Ming'
Fees: ❑ Protective Signaling
L
r Enter total of above fees $ _ ❑ Other
8%State Surcharge $ _Number of Systems
H
J25%Plan Review Fek ' No licensee are required Licenses aro required for all oMer Installadws
See-Plan Review"section on $
front of application. Fees:
Total Balance Due $
J Enter total of above fees =
L J Trust Account N__ 8%State Surcharge
Total Balance Due =
I-\dsts\fhnsWc-fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION ,24ad -QQS`ji,�
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
_ Date Requested a" J
d-�- 0/ AM PM BLD
Location /6 �J,2 �4,.a L '1 Suite _ MEC —
Contact Person Ph G - PLM _
Contractor_ Ph SWR
BUILDING Tenant/Owner _ _ ELC --
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT _
Post&Beam
L-A Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing —
Firewall
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling --
Roof /
Misc:_ — —
Final
PASS PART FAIL
PLUMBING _
Post&Beam
I_Inder Slab _
I op Out
Water So-i vice
Sanitary Sewer /
Rain Drnin-
Final
PASS PART FAIL _
MECHANICAL
Post&Hearn
Rough In
Gas Line --
Smoke Dampers
Final —-
T FAIL
9 Service --
W- Rough In
n UG/Slab
Low Voltage _
Fire Alarm
-- SS ART FAIL — -—
ku
Backtill/Grading
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Mall Blvd
Catch Basin ( ]Please call for reinspection RE: _ _ [ )Unable to inspect-nn access
Fire Supply Line
ADA ! �}
Approach/Sidewalk Date t -�3' v Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection trecotrd from the Job alto.
"CITY OF TIGARD BUILDING INSPECTION DIVISION MST ���ti
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 —
SUP
Date Requested_ s— Z 3 AM PM
BLD _
Location 1 U S�G 7 5'.--, A& ,Py-e S Suite
MEC
Contact Person Ph PLM
Contractor Ph SWR
UIL Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain -`
Crawl Drain Inspection Notes: SGN
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall `
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _
in
zVW PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer ---
Rain Drains
Final
PASS PART FAIL
A
Post Beam
Rough In
Gas Line
Smoke Dampers
Ani
PART FAIL
IC
a Se ice / _
U) Rou In / �Q
N 6Fire
/ n
olt e
Ia S PAR' FAIL
W S
Backfill/Grading -— -
Sanitary Sewer
Storm drain [ Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW 0all Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE: _ I Unable to inspect-no access
ADA
Approach/Sidewalk
otherDate 11 L 3 — 4/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site.
GIT' BF'TIGARD BUILDING INSPECTION DIVISION o;po G
Zu
24-Hour Inspection Line: 639.4175 Business Line: 639.4171
C _
Date Requested ` 7 AMPM BLD _
Location ZU G 7 5w 3 Suite G MEC
Contact Person _ Ph �F/- �� G L PLM
Contractor Ph SWR _
BUILDING Tenant/Owner ELC
Retaining Wall r ELR
Footing Access:
Foundation FPS
F ta Drain — SIGN
zLiMMIN Inspection Notes:
Slab SIT
Post&Beam
Ext Sheath/Shear f
Int Sheath/Shear L V- 6 A `
Fram'ng
Insulation ..---
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm f S J
Susp'd Ceiling T�
Roof
Misc: _ —•
Final
ASPART FAIL
PLU
Post R Beam r---
Under Slab _, G-� �.5 �JL
Top Out �A
Water Service
Sanitary Sewer �--J
Rain D i s,/
)iAVSPART
FAIL
MECHANICAL
Post A Beam
Rnugh In
Gas Line
Smoke Dampers 1
Final ----
PASS PART FAIL
ELECTRICAL
(L Sei 'ire
R Rougo In
UG/Slab
Low Voltage
Fire Alarm
_ Final
PASS PART FAIL — —
W
SITE
A Backfill/Grading — ----
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RF: _ [ ]Unable to inspect-no access
Fire Supply Line_
ADA _
Approach/Sidewalk
Other Date �__Inspector ,�Ex
t _
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job alto.