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11834 SW TALLWOOD DRIVE 1 I 171 I_, 1_ o ,t...i I ,L.I L- I _I 1 -34 SL)�) F M w. Zl', JL 0 t�{f 4 r ', o CITY OF TIGARD BUILDING INSP'FCTJiON DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - ---- 1 BUP L' Date Requested— AM —PM _--_ 13LO I-ocationZ�C�.Suite _ MEG - —� Contact PP =on { �ClJt Ph 'j��- /�� PLM Contracto _ ��,�1� .{� f� L -� PI, _ SWR BUILDING _ Tenant/owner �� <� --- -__ ELC Retaining Wp" ^� ELR --- ---- Footing Access Foundation FPS Ftg Drain SGN Crawl Diain Inspection (Votes: - Slab SIT Post&,3eam - T — ---'— -- — --- (txt 3;,,-ath/Shear '��•� L� __----_._______._.__..____..._. Int Sheath/Shear Framing 1^;ulation Drywall Nailing -- --- -- ---.-__-.._-------- Fir 3wa!I Fi e Sprinkler '=ire Alarm — -------- Susp'd Ceiling Roof 1Aisc: _._._._..._ --------- -------------- -- Final PASS PART FAIL ------- --- ------- --- ---._ __._.._ . PLUMBING Post& Beam -- ------ ---__--.....------------ ----------- -- 'nder Slab 1 op Out ----- ---- ---- - Water Service Sanitary Sewer Rain Drains Final --- -- --- PASS PART FAIL MECHANICAL Post& Beam Rough __ - Rough In Gas Line ----- -- -- - - -- - - ------ Smoke Dampers Final PASS PART FAIL ELECTRICAL - --- —.___ _ ---- ----- --------- _- -_ Service Rough In UG/Slab Low Voltage Fire Alarm —__--- Final PASS PART FAIL —�— SITE Backfill/Grading --- - — - an.tary Sewe [ I Reinspection fee of$_— _ equired before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE:__. [ j Unable to inspect no access ADA Approar.h/Sidewalk —_ Date/J � Ext _er r n S PART FAIL DO NOT REMOVE this Inspection record from the jots site. CITY CSF TIGARD DEVELOPMENT SERVICES PLUMBING FIFRM17 131,',1 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PLM913-02.36 DATE ISSUED: 07/17/98 PARCEL: IS133CD-13400 SITE ADDRESS. . . : 11834 SW TALLWOOD DR SUBDIVISION. . . . : PEBBLECREEK 11 ZONING: R-25 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :O25 JURISDICTION: TIG ("LASS OF WORK. . : REP GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PRE VNTRS. . : 0 C)CCUPIANCY GRP. . :R-'--' FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . 0 STORIES. . . . . . . . . 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . . 0 F I X T*URES--------.—.---.—— LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . . 0 MINKS. . . . . ,. . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAP'S. . . . . . . . 0 LAVATORIES. . . . : 0 OTHEii FIXTURES. . . . : 0 IUB/SHOWERS. . . : 0 SEWER LIKE (ft ) . . . : 100 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Repai4t of sewer line for SF dwelling. Owner: ---------------------------------------- ----------------- FEES LORETTA FODOR type amot-int by date rer-pt 11834 SW TALL-WOOD DR PRMT $ 30. 00 DLH 07/17/98 98-307438 TIGARD OR 97223 5PICT $ 1 . 50 DLH 07/17/98 98-307438 Phone #- 524-7807 Contractor----- ------------------._------- M I CHAEL. ontractor----------------------------------- MICHAEL. & CO PLUMBING V', 0 BOX 23008 fIGARD OR 97281 -------------------------- VIhone #: 639-3189 $ 31. 50 TOTAL. Peg 000678 REQUIRED INSPECTIONS ------- This permit is issded subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 18e days of issuance, or if work is suspended for uore than 188 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-98AI-90II through DAR 952-Wl-*98. You may obtain copies of these rules or direct questions to OM by calling Tsso-ted By : d Permittee Signati-tre: /M rnittl V 1-++++4........... ......................*++.4-+4..........I...........4.............. Call 639-4175 by 7:00 p. m. for An insppr-t4, on needed the next btisAiness day 4+++++++++++++++++++.++++++•f+++++++++++++-1++++-4-++++++++ .......... 1-+ .4TY OF TIGARD Plumbing Application Recd By_.), Datil Recd ? 3125 SW HALL BLVD. Commercial and Residentiai Dale to P E ,:GARD, OR 97223 Date to DST_ Permit t 639-4171 i/:',503) Print or Type Related SWR t Incomplete or illegible applications will not be accepted Called _ —� Warne FIXTURES (Individual) —� QTY PRICE AMT of Development/Project Sink 9.00 .lob Lavatory 9.00 Address Street Address Suite - — I 3 -S U-� T k �rI) Tub or Tub/Shower Comb -_ _ 9 OU Bldg a CitylSlata Zip Shower Orly - 9.00 Water Closet _9.00 Name r Dishwater 900 U Garbage Disposal 900 Owner Mailing Address Suite Washing Machina q 00 18,3S e 1k Wpks r- - CitylStale Zip Phone Flair Orz!r 2" — 9.00 .oI f 23 J�`S 78ri1 3' 9.00 Nar 4" 9.00 - - water Fleeter 9,00 Occupant MmlIng Address - Suite _ _ Laundry Poom Tray 900 CdylState Zip Phone Unnal 900 Other Futures(Specify) - 9.00 Name 900 Li ailiriQ Address Suite --T 9.00 Contractor - `- 900 City/State Zip Phone 9.00 j� ,j O Ct�2�/ (0-3 a1A — 900 Ore on Const.Cont.Board Lic.0 Exp.Dale -- 9 00 Attach Copy of Y7 7 I ti 9 _ Current Plumbing Lic.9 Exp.Drte Sewer-1 st 100' _ 30.00 ` C�p l: Licenses (-- '3 3 3 11- 3 0'y 8 Sewer-each additional 100' 25.00 COTBusiness Tax or Metro a Exp Date ` I Water Serneet-1st 100' _ 3000 Water Seance-each additional 200• 2500 Name -- Storm 6 Pain Drain-1st 100' 3000 Architect - Storm S Rain Drain-each additional 100' 2500 or Mailing Address Suite - 25 00 Moble Home Space City/Stale - Zip Phone Commercial Back Flow Prevention Device or Anti- 2500 Engineer Pollution Device Residential Backflow Prevention Device' 15.00 "scribe work New O Addition J Alteration O Repair to be done Residential Nix,-residential O Any Trap or Waste Not Connected to a Fixture - 9(0 �Cdibonal descnplon of work S Catch Basin 9.00 Insp.of Existing Plumbing ♦0.00 _ _ -perfir _ - Specially Requested Inspections 40.00 —� -xisfir j use of — r/hr i•nt,ling or property Ra n Drain,single family dwelling _ 3000 G-r ase—Traps 9.00 �`mposed use of — bu'Iding or property--QUANTITY TOTAL I' 1.amot or fter diagram b murrw N Ouenly Total Is *.9.- Are you capping moving or replacing any fixtures? Yes p No p -- 'SUBTOT/%L (�lf.�es.--s--ae-back of form) l II hereby acknowledge that I ha re read this application.that the information ----- 5%SURCHARGE given is correct.that I am the owner or atrthonzed agent of the owner,and that plans submitted are in compliance wllh Oregon Stale Laws PLAN REVIEW 25%OF SUF,DOTAL Sign"of ownerfAgent Data Repuired on I fixture total is�•9 _ TOTAL ontact Person Vame Phone •�Alnlmum permit fee ks 325+5%surcharge,except Re►ieenit I Backflow .3 Preven;;on De-Ace.which is 315*5%surcharge `/ l:tdstsblmapp.doc SM CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Flvd., Tigard,OR 97223 (503)61'19-4171 CERTIFICATE OF OCI:UPANf:Y F'E:r�MI'f #. . . . . . . i MST96-•0492 DATE I SSUECD a 12)6/27/97 PARCEL s 1'S 1;33Cr)-1 400 6I TE ADDRE GS— s 11834 SW TALLWOOD OR SUBDIVISION. . . . c PEBBLECREEK 2 kONIN5pR_-25 BLOCK. . . . . . . . . . . LOT. . . . . . . . t25 JURIGDICTIOIVs1'IG CLASS OF WORK. s NEW TYPE OF USE. . . :aF TYPE:. OF L'.ONST R s RN OCCUPANCY GRP. s R3 OCCUPANC✓ L.OADs,' RpInz., I r, , Ntw tiingit-family midence PATH I COSTA PACIFIC HOMES a625 SW ( ASCAI)1 . STE, x,06 BE:AVE RTON OR 97009 Phone Mo 646-8888 l:not ract or_ COSTA--PAC I F I L i-!QMES t URA R A K DEVELOPMENT) 862:5 SW CASCADE AVE GTE 606 SFAV;-P..TON OP 97005 Phone IM: 503 646-13088 Pep 0. . a 000651 This Certificate grants oc't-uparjc,y of the above referenced building or portio-1 tt)ereof and (-onfirms that t;he tuildi.ny has heron inspected for compliance Witt) the State of Ov-eyorr Cpperialty Codes for the grog, occuCsanc_y, and use ;ander Which the referenced enced permit wa'► is<.al.itd- BU I LI)I NCS PAL AL �IJIL.UINC3 - SPECIOR POST IN CONSR I C;UOUS PLACE L� f Page No 1 CASE HISTORY FOR CASE NO.: MST96-0492 COSTA PACIFIC HOMES 11834 SW TAIJWOOD DY 09/21/97 Action Description Req/ scbd! End/ Actium Noten Disp By Update Upd code Sent. Gone Done Date By M9TA003 Application received / i / / 10/14/96 PARS JMH 10/17/96 PHN M.9TA005 Application received 03/04/97 / / 03/04/97 03/04/97 RAS MSTA008 Permit created / / / / 10/17/96 PASS URA 10/17/96 PHN MSTA010 check for prcl. restrict.. / / / / 10/17/96 PASS DRA 10/17/96 PHN MSTA012 Plane routed to Plane Examiner / / / / 10/17/96 PASS DPA 10/17/96 PHN MSTA026 Plana approved by Plana Rxmr / / / / 10/19/96 PASS RT 10/19/96 BT2 MSTA030 Reviewed plans routed to DSTS / / / / 10/19/96 PASS RT to/le/96 BT2 M91Aoe0 (F) Ready to issue / / / / 1.0/22/96 PASS B 11/22/96 BON MSTA092 (F) Isnue combirst-ion permit / / / / 11/15/96 PASS DRA 11/15/96 DRA MSTA097 Issue plumbing signst*.re form / / / / 12/02/96 OR DRA 12/02/96 WAS 14STA090 Inoue electric mi.- -,tore form / / / / 12/02/96 OR .')RA 12/02/95 RAS MSTA705 Protinq Inup / / / / 11/21/96 pending- ufer tagged; keyway; seismic PASS RB 11/21/96 RB -estraint; muck footing. Una 11 19 MSTA706 Foundation insp / / / / 12/03/96 APP RS 12/01/96 RBS MSTA710 Post/Beam Structural / / / / 12/19/96 2-nails per Tji at fearing req'dj plans FAIL PH 12/19/96 RH call for TJT-35 - 1.5's installed et 16^ ctro; fill web member for anchoring MPAHD-22 straps- both s'.das; TJI end nailing rim to joist- nail Loth top and bnctom flange; mach not ready under-floor plumbing dome on wrong dwelling address plumbing card (ok) MSTA710 Poet/Beam Structural ! / / / 12/24/96 TJI change submitted- approved; remove FAIL RB 12/24/96 RB flex from floor cavity; previous corrections incompleted MSTA710 Post/Beam Structural / / / / 02/13/97 :evision for TJI's received prior- ok PASS "B 01/13/97 RR MSTA711 Poet/Beam Mechanical j / i / 12/19/96 FAIL RA 12/'9/96 RB MSTA711 Post/Ream Mechanical i / / / 12/24/96 pending- removal of, flex from floor PASS PH 12/21/96 RA cavity. MSTA117 Pim/Underfloor +N+M / / 12/1.9/96 trap arm nesde to be strapped up FAIL MS 12/19/96 Mw' need to insulate pipe MSTA717 PLM/Underfloor / / % / 12/2n/96 PASS MS 12/20/96 MRS MSTA720 Mechanical Inep / / / / 0!/04/97 q..1. mechanical installation not DIS RS 02/04/97 RBS complete MOTA720 Mechanical Inep / / / / 02/07/97 see fusing this date FAIL RB 02/07/97 RB MSTA720 Mechanical Tnep % / / / 02/10/97 pending- enclose lid of chase upstairs & PASS PB 02/10/97 RB ae, floor (firsotopping issue) A Page No. 2 CASE IIIS'PORY FOP CASE NO.: MST96-0492 COS"A PACIFIC 110M.5 ]1814 rw TAi,LWOOD DH 06/21/97 Action Description Reg/ aced/ find/ Actl m Noten ninp By Update t/pd code sent Done Done Date By ------- ------------------------------ -------- -------- -------- ----------------------------------------- ---- --- -------- -- META722 Plumb Top Out / / / / 02/04/97 328 ON WM , NO TEST ON NASTR D' ; ra 02/04/9"1 UES MSTA722 Plumb 'lop Out / / / / 02/05/97 test waste thru rooft DIS GS 02/05/97 OEs no test an wtr M8TA722 Plvmb Top Out / / / / 02/07/97 wtr ok, on test on waste DIS 08 02/07/97 028 MgTA722 Plumb Top Out / / / / 02/10/97 APT OB 02/10/97 0118 NOTA723 electrical Service / / / 02/03/97 PASO MJR 02/04/97 MJR MSTA724 Electrical Row.h In / / / 02/03/97 PASS MJR 02/04/97 Mn NDTA725 Framing Insp / / / 02/C7/97 meth issues- soffit duct in garage; FAIL RD 02/07/97 kH fireplace combustion airy enclose lid of heat duct chase upstairs - also, floor; fire-block wall greater than 10t; stair guardrail/handrail too low at 30"; vont baffle missed ac main antryt strap plate w/in fwd bedre. upstairs; Perlin brace needed at trungem. MSTAUS Framing Insp / 1 / / 02/10/97 plumbing top-out failed; mach issue; PAIL RD 02/10/9 PB post/beam issue; vent baffle over entry too short. NSTA725 Taming Insp / / / / 02/13/97 pending- poet/beam i8e110; access in PArr PH FN garage; NWA726 Shear Mall Insp / / / 1 02/04/97 M-1- HTT-22- holdowns not installed at DIB KS 02/04/97 YBA rear of structure 8-2- mat straps not inplace at garage header 8-3- additional nailing needed at shear panels MSTA729 Shear Nall Insp / / / / 02/07/97 CB-16 x 491" ntrxpn minned at PAIL RD 02/07/97 PA garage/dwelling connection; strap i < a slain entry to adjacent wail plate; not secured at fireplace and west rrar well corner; MSTA726 Shear Nall Insp / / / / 02/10/97 PASS RD 02/10/97 RD MOTA735 Gas Line Insp / / / / 02/09/97 8176105 PASS RD 02/05/97 RD MBTA740 Ineulatien Insp / / / / 02/13/97 pending- framing issues; insulate garage PASS RD 02/13/97 RB ductwork; fi.reetop thru penetrations-marked; chink window/doors where nesdod. Page No. 3 CASE HISTORY FOR CASE NO.: MST96-0492 COSTA PACIFIC HOME; 11834 SW TALLWOOD DR 00/21/97 Action Description Reg/ Schd/ Fred/ Action Notes Disp By update Upd code sent Done Dane Date $y ------- ------------------------------ -------- -------- -------- -------- --------- ---- --- ------ '-- MSTA745 Gyp Board Insp / / / / 02/19/97 PASS RB 02/18/97 RB MSTA755 Rain drain Insp / / / / 12/10/96 PASS MS 12/IG/96 MRS MSTA760 Water Line Insp / / / / 11./10/96 PASS MS 12/10/96 MRS MSTA765 Appr/Sdwlk snap / / / / 02/26/97 1. Remove curb cur_ uection and form for DIS Pi 02/26/97 RAS now MSTA765 Appr/Sdwlk lnap 03/04/97 / / 03/03/97 1 BOAP2iS A'r APPROACH TO fl-MWALA. PASS PI 03/04/97 AAS M3TA711 «REINSPECTION— / / / / 7 plm top 'n1t 2.5-97 $25 GS 02/07/97 DST Paid 02/07/97 97-290090 Jed MRTA771 «REINSPRCPION» / / / / 02/07/97 02/07/97 MRS MSTA790 Electrical Final / / / / 04/29/97 PASS TLP 05/01/97 TLP MSTA795 Mechanical Final / / / 05/14/97 nee building final this date FAIL RA 05/21/97 RB MSTA795 Mechrnical Final / / / / 06/26/97 PASS GS 06/26/97 J+H MSTA797 Plumb Final / / / / 05/14/97 PASS MS 07/28/97 JT MSTA799 Building Final / / / / 05/14/97 vent wells FAIL RB 05/21/97 RA gas line conection to fireplace trim missing at main entry aide li.tas caulk master shower enclosure extend dryer van. .-g into laundry handrail too wide meal refrig line at ext. support refrig line under-floor remove crawl debris dryer venting- monuf instal. inuuu plumbing final inter pony wall u/f needs te, be ne�ured W/ anchors MBTA729 BLildlnq Final / / / / 06/26/97 PREVIOUS FINAL CORRECTIONS APPROVED - PASS GS 06/26/91 J-H okay for cofO MSTA960 (F1 Issue C%rt. of Occur racy .1 / / / 06/27/97 mailed 9/21/97 JT 09/21/97 s*W M.S'rH708 Eroniar Control / / / / 05/13/97 PASS USA OS/21/97 RB CITY OF TIGARD DEVELOPMENT SERVICES MASTER PIERMI"F 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 FIERMIT #. . . . . . . DATE ISSUED: 11/15/96 PARCEL-: IS133CD—PB1125 S I 1JE ADDRESS. . . 11834 SW TALL.WOOD DR SUBDIVISION. . . . PEBBLECREEK 2 ZONING: R-25 BI..00v,. . . . . . . . . . L_O*T. . . . . . . . . . . . . :25 Remarks: New single-family residence PATH I -------------------------------•------------------------------ BUILDING -----—-----------------------------—-----------—------------- REISSUE, STORIES.,,....: 2 FLOOR AREAS--------- BASEMENT,.,: 0 sf RE(?UIRED SETBACKS---- REQUIRED------------ - CLASS OF WORK..-NEW HEIGHT2....... 19 FIRST—.: 1042 sf CIM.....: 489 sf LEFT.........,: 5 SMOKE DETECTRS,: V TYPE OF USE....qF FLOOP LOAD....: 40 SECOND..,: 476 sf FRGNT......... 15 PARKING SPACES: i TYPE OF CONST.:5N DWELLING UNITS: I F I NBSMENT: 0 5f RIGHT.........: 6 OCCUPANCY GRP.:R3 BDRM- 2 BATH: 3 TOTAL-----: 1518 sf 110200 REAR..........: 15 ---------------------------------------------------•----------- PLUMBING ------------- SINKS,....,,. ..: ---------SINKS........ . I WATER CLOSETS.: 3 WASHING MACE',,: I LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS,....,.,.: 0 LAVATORIES,...: 4 DISHWASHERS... I FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCA BASINS,.: 0 TUB,*SH(YkRS,..- 3 GARBA(f DISP.. I WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PRLVNTR: I GREASE TRAPS..: 0 31HFR FIXTURES: 0 ------ MECHANICAL -------------------------------------- FUEL TYPES------------- FURN ( 1001! I BOIL/',MP ( 3HP: 0 VENT FANS....,: 4 CLOTHES DRYERS: I /GAS/ ! / FURN )=1001! 0 UNIT HEATERS..: 0 HOODS....,....: I OT14LP UNITS..,: I MAX INP., 0 BTU FLOOR FURNACES: 0 VENTS......,..: 0 WOODSTOVES..... 0 GAS OUTLETS.,,: 1 -------------- -------------------- ELECTRICAL —RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- —TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS----- --ADDIL INSPECTIONS-- 1.000 NSPECTIONS—100@ Sr OR !ESS: I @ 200 amp..: 0 0 - 200 alp..: 0 W/SVC OR FDR..: 9 PUMP/IRRIGATION: 0 PER INSPECTION: ',) EA ADD'L 5005F.: " 201 40e asp..: 0 201 - 400 asp..: 0 1st W/O SVC/FDR: 9. SIGN/OUT LIN LT: 0 PER HOUR......: 0 1-INiTED ENERGY.: @ 4011 600 amp..: 0 401 - 600 alp..: EP ADDL BR CIR: e SIGNPL/PANIEL...: 0 11*1 PLANT......: 0 MANF HM/SVC/FDR: 0 6e1 - 1000 asp.- 0 601+alps-1000 v; 0 MINOR LABEL -10. 1 1000+ amp/volt : 0 ------------------------------- PLAN REVIEW SECTION -------------------- --- Reconnect ---------- Reconnect only.: 0 )=4 RES UNITS.,: SVC/FDR)=E,25 A.: 600 V NOMINAL: CLS AREA/SPC OCC- ------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ---------- - ------------------------------------ A. ----------------------------- A. SF RESIDENTIAL-------------------------- B. COMMERCIAL---------------—-------——--------------------—--—-—----------------- - P1JDI0 & STEREO.; VACUUM SYSTEM.. AUDIO 9 STEREO. FIRc W..ARM..... INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALAPM_: 0TH: X BOILER..,,.....: HVAC...........: LANDSCAPL7/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK..,.......: INSTRUMENTATION: "ECIC.._........: OTHR: HVAC...........: DATA/TELE COM.- N'ISE CALLS...,: TOTAL # SYSTEMS: 0 Owner: TOTAL FEESO 4451,27 COSTA PACIFIC HW COSTA-PACIFIC HOMES 8625 SW CASCADE STE 606 8625 SW CASCADE AVE STE.6K BEAVERTON OR 97005 BEAVERTON OR 97005 Phone #: 646-8888 Phone #: 503-646-888P Reg #,.: 6°.157 Tl,, permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Special y Codon and all other applicable laws. A)) work will be none in accordance with approved plans. This pet-tit will expire if work not started -ithin 2m^ days of issuance, or if work is suspended for more than i80 days. REGUIRED INSPECTIONS ------- 000ting Insp PLM/Underfloor Craving Insp Gas Fireplace Water Service In Builuing Final - ------------ IFoundation Insp Mechanical Insp Shear Wall Insp Insulation Insp, Appr/5dwlk Insp Erosion Control Post/Beam Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final Post/Beal Mechan Electrical Servi rit,pplace Insp Rain drait, Insp Michanical Final r Crawl Drain Electrical Rough Gas Line Wisp Water Line Insp ft1b Final ll,ei-in i t t;P e Signat I S"1�1 ed I,y lit,k, : - 4A vo��_ Cal I f o t- i ri s pE�ct i oi -- 639-41-75 CITY OF TIGARD SE:WFR CONNECTIO11 DEVELOPMENT SERVICES F,EP!+IIT L� 13125SWHall 81vd., Tigard,ORb71?3 (503)639.4171 PERMIT #. . . . . . . : SWR96-0493 DATE ISSUED: 11/15/96 PARCEL: 1 S 133C D--PB 1 I c5 1;1 TF ADDRLSS. . . : '11834 SW 1 A1.-1_WU01? DR SUBDIVISION. . . . : PEBBLECREEK c ZONING: R-25 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :225 I f4 NONT NAME. . . . . USA NCI. . . . . . . . . . : FIXTURE UNITS. . . : 0 CLASS OF' WORK. . . :NEW DWELLING UNITS. . : i TYPE OF' USE. . . . . :SF NO. OF' BUILDINGS: 1 INSTALL TYPE. . . . :BIJSWII I MPERV SURFACE: 0 s f rlemar-ks : New sinyl.e—family residence Owner.: _.._._._.._._._._._._.._,.----.____._________ _..----___..__.....-.-.__.-_...._.._._____.._._ FEES COSTA PACIFIC HOMES t ype amoLint by date recpt 8625 SIA CASCADE STE. 606 PRMT $ 1-2200. 00 URA 11/15/96 96-2865137 INSP $ 35. 00 DRA 1 1/15/96 96--286587 BEAVERTON Oft 97005 Phone #: 646--8888 Contractor. CONTRACTOR NOT ON FILE Phone H : $ 2235. 00 TOTnL Reg #. . : ------- REOUI RED INSPECTIONS - - - This Applicant ;greos to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires Al 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 prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "iap and Side Sewer" Permit and the Aqppq will instalj-.a lateral. Pov-initt 14 s i-i e d Call for inspec.t i.on — 639-4175 Pian Checx X.. t:,iTY OF TIGARD Residential Building Pei -nit Application Recd By : f_ 13125 SW :MALL BLVD. New Construction Additions or Alterations Date Re-� /0 i rf TIGARD, OR 97223 Si►tgle f=amily Detached or Attached Date tc P E..,Z-/7-%, (303) 639-4171 Date to DST.10• t� Print or Type Permit x M 5r3l�t�4q�, Incomplete or illegible applications will not be accepted called l Name of Suddrvrsron r n a - N me Jos ��b1� �-Pf, _ U .. 11 IIry Address G.trArchitect arli g dr Pr ss rMg1mg tyDtatnl<.a.r/f'✓ v�It�ZL Phn� Owner s7a n Add:essL eerte Ei�7a � NameI�hoL��$ I General � 'r' vlJ� —• JC.-1n� Q✓ 6�f'� 1 t t + Cescabe worx ne addition C aiteratron O emir O Contractor Mailing Address to de done I Adrtrtronal Descrnouon of Work: CdyrState Zip Phone Oregon Const.Cont. Boant Lrc.x Exp. Date Attach Copy of r; ! I a--�J ,_ Project Current COT Business Tax or Metro 9 Ex Date I ( i J- Valuation Licenses Nv ec.-•�,�c� h;F ,fir SF- t-.-17 I NEW CONSTRUCTION ONLY: Mechanical G��h Zc, 1G��1�C� ^Sq.Ft W- -^_ Sc Sub- Marling Adores! Contractor �j,5 1�� ;( �. I Camer Lot Yes No Flag Lot Yes ity/St�tf� z)pRC'El Phhcne1 (check one) � (check one) �1. —W-2 i ✓I '��'v V' Q , Restncted Audio stereo Burglar Oreyidn 1orL5tunt. Boars L,c a 1 / L atacn copy or L rArg�fl Energy System v Alarm Current COT )r Hess Tax or M Biro tt - D ' InstDllation Garage Ooor HVAC tJcenses O I_ 1I f i Opener I Systertis N��e I (check all that fOOther:Flurnbing O(C cooly) Sub_ Marling Address Will the electrical subcontractor wire for all Yes I NO Contractor �)OX 1�� restricted eneray installations? C P_rstate �wl�" Has th Subdivision Plat recorded? N/A I Y14" No 'P1 I��la m D . �� - CID ?�� i;Oregcn ons o t. Board L,c.� Ex �at ' Solar c:omp0ance AM-ch Copy of �j � I I� i _C� l -J _ �,_ i (Calculation Attached) ..� Current P mg,L�ac. j t { I hereby acxnowiedge that I have read th,s aooucahe.t, that the Licenses %/Jinformation given is correct. tt at I am the owner or authonzed agent of C� mess a 9f p t tt,e owner. and that plans submr;ted are in romol�ance with Oregon _ 41 CA1 _ State ws Electrical Na �l( + sig t I 7TV Sub- Madrnq Address _j �_ �I�,) Contractor `'f)1S,,, ��'t Tv �Le,�2(lm FOR OFFICE USE ONLY: �ryv hoe �� Plat ,— - MaptTL# Ore n Board Lic.x ate Cl 1 1 l ( a 1. Ul/ I I'Cj 13, C,()— g 1 Ic Attach Copy of Setbacks I Zone: Solar. r Current F! L:c licenses D7la�� t� } i coT �ie ax u htetr 3 j.� 0 e p�eEnng,gopfval Plannnno Ac-royal TIF �(i(,c, �Itt ff'' atsvr� Sop aoc �k • � �_. ( ` J r•✓ �� \ �;`�C �. � .� Permjt AccountDescription mount A P Bal. D permit (BUILD) �o 5-1 Plurnb. Permit (PLUMB) 14? Mer;h. Permit (MECH) / 3. �ti _ 3• -�l ELC/ELF Permit (ELPRMT) _ State 'fax (TAX) Bldg: d�•U3 Plumb: Mech: 02.1 ELC/ELR: t�U• Plan Check c1C• -JbYl 3.3 MST: (BUPPLN) ,%% , �'C,� uc� elf Plumb: (PLMPLN) Mech: (MECPLN) CDC Review (LANDUS) 5,,e?( -61P-lSewer Connection (SWUSA) _ 200 Sewer Inspection (SWINSP) ✓ _ 3Sw Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Water Quality (WQUAL) �- Water Quantity (WQUANT) --- GU Erosion Control Permit (ERPRMT) Erosion Planck/USA (ERPL6,N) Erosion Planck/COT (EROSN) Fire Life Safety (FLS) TOTALS: i.\dst9\mstapp.doc RF-,v 7/96 �_�_/