12665 SW 138TH PLACE h1DDr
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: -
Post/Beain Mech. San. Sewer Gas Line Bldg "L
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �� � Time: AM PM?'
Address:
J
Builder:---? � f Ste_ Permit #: �J� ` d Ct
THE FOLLOWING CORRECTIONS ARE REQUIRED:
T
F-
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Inspector. _ Date:
"--�PPROVED DISAPPROVED APPROVED SUBJECT TO nBOVE
_ _Call For Reinsp.
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MST95-0066
13125 SW Hall Blvd.Tigard,Oregon 97223#8199 (503)639-4171 DATE ISSUED: 02/15/95
PARCEL:
-)iTE ADDRESS- : 12665 SW 1313TH AVE
;UBDIVISICIN. . . . . ROSE MEADOWS ZONING: R
1-3LOCK. . . . . . .. . . . LUI.. . . . . . . . . . . . . 02 1
CLASS OF' WORK. . iNEW GARBAGE:' DISPOSALS. . : 1
TYPE OF* USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRES. I
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WP1ER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
F I L(-4UNDRY TRAYS. . . . . : 1 Sl- RAIN DRAINS. . . . . : I
SINKS. . . . . . . . . . .. i GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 O'Tl ;;: FIXiURES. . . . . .0
TUN/SHOWERS. . . . : SEWI-R LINE (ft ) . . . . :0
WATER CLOSETS. . 3 WATER LINE ( ft ? , . . . . 100
DISHWASHERS. - : 1 RAIN DRAIN ( ft) . . . . :0
k e m a t^k s . 1=,(A TH I
UW114LH: --•_-___--___._-_____-----.-__-__
JAY MILLER TIF $ 1550. 120 JF 02/15/95
P (i LAUX LIau91 SWIM $ 180. kO J F' 0,2/15/95
GWM 11 100. 0 6 JF 02/ 15/95
-
T1 iARD OR BPR 1 41)6. 00 JF 02/15/95
Phone #: 684-7543 BPLC 50. 00 JF 02/10/95 95-26160--
D5PC $ ---,4. 90 JF 02/15/95
i-.111-tinhinn Contractor : -------•--
PARK $ S00. 00 J1- 02/15/g5
MPRT $ 43. 50 JF 02/15/95
; Imfflc .,.-Ken Watts Construction Inc-*-- MPLC $ 10. 86 1 F 02/15/95
Hdat-ess, . fO '--",- " - M5PC t 2. ib JF 02/15/95
Lx t - arcl, &-fiE t'A t P . -41, 3B TH $ 225. 1014 11: 02/15/95
Z i P h no# -q(1-3 P5PC $ 11. 25 JF 02/15/95
He- Additional foes not shown here. . . . . . . . .
REQUIRED INSPECTIONS
This permit is issued subject to the reg-
ulations contained in the ligard Municipal Footing Insp Insulation Insp
Locie, State of Ore. -pecialty Codes rand all F'oundat ifin Insp Gyp Boar-d In ,p
other applicable laws. 011 work will be done Post/Seam Stt,uct Rain dr-ain Insp
in accoi-dance with approved plans. This Post /Pp,-im tlechan WAter, Line Insp
permit will expire if work is not started Crawl Dr^atri Water Service In
within 18LA days of issuance. or if work is Plm/unditlatj Insp fAppi-/GdwIk Insp
suspended for, more than 160 days. PLM/Under-f I oor Mechanical Final
Mechanical Insp Plumb Final
Plumb Top Out Building Final
(A Framing Insp Erosion Control
>- Fireplace Insp
Gas Lirl ? Insp
..km 1-1 1 1 1�
)�r
-1 E.1 C tlac InAt i.ire
Call for" inspect- lon 639-41'75
Uj ontr-actot- Notes.,
.................
CITY OF TIGARDvl
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 SW Hall Blvd.Tigard,Oregon 97223*814 (603)639.4171 1--,ERMIT #. . . . . . . . MST95--0V,,68
DATE ISSUED: 02/15/95
PARCEL: 2S1048D-RM0a.1
_3ITE PDURESS. . . : 12665 SW 138TH AVE
3UBD I V I S I ON. . . . : ROSE MEADOWS ZONING: R-7
L'LOCK. . . . . . . . . . : LOT. . . . . . . . . 0e.I
BUILDING --------------
REISSUE:MST9)000b DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s
CLASS OF WORK. :NE6 BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . 00 Sf
I YPE &r USE. . . :qF FLOOR AREAS-_.--_._.--_--- REC-,!UIRED
IYPL UF CONST. :5N FIRST. . . . :970 s LEFT. . :5 ft RIGHT'. :5 ft
OCCUPANLY GRP. :R3 SECOND. . . :864 s f-RONT. :20 ft [REAR. . :38 ft
:31URIES. . . . . . . :2 FINBSMF-N!f-.0 S f: RE QU I RED--
iiEIGHT. . . . . . . . :24 -Ft TOTAL-: 1B34 S f SMOKIE DETECTORS. : Y'
F=LOUR LOAF). . . . :40 psf VALUE. . . . . $ : 125094 PARKING SPACES. . : 1
Remarks : PATH I
PLUMBING ------------------------------------------
SINKS. . . . . . . . . . .. I FLUOR DRAIN3. . . . :0 SAC'iFLOW PREVNT RS. . I
LAVH TORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. 0
1'UB/SH(JWERS. . . . ,3 LAUNDRY TRAYS. . . : 1 CATCH 0
i�J$4'I LR LLUSETS. . o3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . tO
DI SHWASHERS. 1. 01HER FIXTURES. . . . . :0
WATER LINE (ft ) . : 1.01 0
CiAkBAGE D I SP. I RAIN DRAIN ( ft ) . :0
WAGHING MACH. . . : 1 SF RAIN DRAINS. . I
MECHANICAL FEES
D=UEL TYPES- UNIT HTRS. . :0 type amoutnt by date reL-pt
/G A 6/ VENT'S . . . . . :0 TIF $ 1550. 00 JF 02/15/95
1AX INPUT :O OTU VENT FANS. . :4 SWM 180. 00 if: 0,1/15/915
-UHN ( 100K . . : I F40ODS. . . . . . : 1 SWM f 100. 00 JF 02/15/95
FUPN ) -10011, . . -0 W0('_1D5TOVES. :0 BPRT 11 41)13. 00 J1- 0E/15/13 15
F,LOUR FURN. . . -0 CL.J DRYERS. : I BPLC 50. 00 JF 0c/10/9.5 95-261602
'3011_/CMP ( 3HP.10 OTHER UNI*T5- 1 LA5PL * 24. 9111 Jr- 02/15/95 -
GAS OUTLETS- 1 PARK $ 500. 00 JF 02/15/95 -
tiwneri $ 4:3. 50 JF 1212/15/95
JHY MILLER MPLL $ 10. 88 JF 114c.'/I b 95
i , 0 DUX 23291 M5FIC 11 2. 16 if- VIL_" 15/9b
3BTH $ 225. 00 JF 02/15/95
I IGARD OR P5PC 4, 11 I. 2-'5 JF' 02/ 15/1)7)
,-:111one #.- 684-7543 EROS $ 64. 00 JF 02/15/95
,_ontractar: s 20. 80 JF 02/15/95
JAY MILLER ERPC $ 20. 80 if: 02/15/95
JU BOX 23291
iibP4HD OR 97281
Ln 1 ,harie #: 684-7543
qegto. . 1 .30109 _----_.---.-_______--_._________....___.___-____
$ 3301. 31. To"rAL
'his permit is issued subject to tho reqQlations contained in the ------- REQUIRED INSPECT 1ONS
igard Mu"icipal Lade, State of Ore. Specialty ;.odes and all other Footing I_zp Plumb Top Qt.tt
L3
W applicable laws, Ail work wi4l be done in accordance with approved Fo(.(ndation .'nsp Framing Insp
plans. This permit will expire if work is not startpd within 180 Post/Seam StrLtct Fireplace Insp
days Of iSSLAnCf, or if work is susp Post/Beam Mec,han Gas Line Insp
Crawl Drain insulation fn,.q..
i-ermitLee 1.3 yna —, 1,4m/,_indsJ.ab insp Ljyp Soxrd Insp
PILM/Underf loor Rain drain Insp
ISSLte'd By : Mechanical Insp Water Line ITISP
@oil #@I- *140pletia'14 609 4*01A
CITY CSF T I CARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PE-RMI 1
13-.15 SW Hall Blvd.Tigard,Oregon 972234199 (503)639-4171 PERMIT #. . . . . . . : SWR95-17,069
Ln DATE ISSUED: 02/1'15/95
PARCEL: 2SI04BD—RM021
SITE PDDRLSE5. 12665 SW 138TH AVR
SUBDIVISIUN. . . . ROSE MEADOWS ZONING: R-7
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . .&'--,1
----------------------------------------------------------------------------------------
I-EN(41\11' NAME.
FIXTURE UNITS.
USP Nu. . . . . . .
CLASS OF "uRK. . . NE14 DWELLING UNITS. . : 1
VYPE OF USE. . . . . :EF NO. OF LAUILDINILS: 1
INSTALL TYPE. . . . :bUSWR IMPERV SURFACI"7. .
Remar-��s : PATH I
Owner,. FEES
JAY MILLER tyl:)e amoi-tnt by date v,ecpi.
P U BOX 23291 PRM-1 $ Ei?00. 00 JF 02/15/95
—
INSP $ 35. 00 JF 02'115/95
TIGARD OR
Pnone #: 664-7543
Contractor. --------------------------------
CONTRACTOR NOT ON FILE
2-235. 00 T0,rAL
Reg
REQUIRED INSPECTIONS
This Applicant agrees to comply ath all the rules and regulations Sewer, Inspection ..........
of the Unified Sewage Agency. Thr permit expires I&) days from
the date issued. The total amount p.lid will he forffited 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 to located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Pgency will ins N 1/) lateral,
Pei,rnittee SigTiatl-tl-e -
I ssl.ted By
Call for inspection 639-41-15
cc
Lf)
CITY OF" TIGARD RFCETPT CIF r'flN'Mr.NT RFCrIPT NCI. l9b-26 160'r
CHECK AMl-.lUllJT 41. 00
NAIYIE;: JOY MILLER 01-DR CA94-4 AMOUNT LA
POYMENT DATE-
SUBDIVISION
I-,URPOSE OF 1,N)YMENT AMOUNT PAID PURPOSE OF F.-'AYMF:NT AMOUNT PAID
50. 00
,uoul,, #2-24R
OF LOT 10, ROGF-.' MEADOWS/tiR665 131ITH
TOTAL AMOUNT PAID - -4 30. 00
C11-e OF TIGARD RFC.'[:'IPT OF PAYMENT RrcF- ,,r No. t 95-P6 1140
CHECK OMOUNT & 5486I
NAME JA'! M11-1-ER BUILDER9 INC CASH AMOUNT a 0. 00
AD 1)1�E.Gif-') Po bOX P30459 PA,eMENT DATE OP 1 9 5
c31.18D I V I S I ON
TIGARD, (3REGnN 97281--
OF PAYMENT AMOUNT PAID pURpoqF OF PAYMENT AMOUNT PAID
F"Ll ING PERM 225. 00
ct 6�6
14jwCtJANILAL PE' 43. 50 ST. BUILD PFR
02,00. 00
PCAN CHECK FE 10. AS SEWER LISP 500. 00
PARKS 8DC
:EWER loSPECT 3113. 00
RESIDFNTIAL. TRAFFIC FEE!.; 1430- 00 MASS TRANSIT TIF FEES 120. 00
HPO QUALITY FAC 1 0
IL.Ily FEE 180. 00 Hao QUANT I TY FACILITY FEE 100. 00
f-F?t,jv'1(3N CONTROi-
�4 PERMITFEF 64. 00 EROSION CONTROL. PLAN CK
0
ui -postoN CONTA01. 20. 80
1p665 RW 1313TH AVE
ROSE mE:nnOWS L-OT P-1
TOTAL pMOljNT PAID 5486. Z:1
Residential Building Permit Application Vk�
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 035.4171
Jobsite Address:_' ' � "�
/
Subdivision: " C �'1((�do Lot # 21 Office Use Only
Planck/Rec #
Valuation
Permit #1:" r %-5,.,..i 0 --
Corner Lot? Y N _
Reissue
Flag Lot? Y N
Map & Tl_ #
Owner: i `) vi �'►'` _ Approvals Requlred
Address: Planning
�l Q -72-O ( Engineering _
Phone:
Other
Contractor: Items Reguired
Address: Subcontractors
Truss Details
Phone: Other _
Contractor's License # 0 Ll 0/X
(attach copy of currene Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Enginger: OMA Mvl+f,
'Plumbing: 6M Address:,z)3 jVU Toot
Mechanical.
(attach copy of current OR ntractor's License)
J _
7
JOB DESCRIPTION:
J /I
App cant Signature-& Phone number
Received by: Date Received: ��b I✓ _
NAW0A0=M0E'AAE8APP
Permit# /Account Description Amount Amt. Pd. Bal. Due
1)1—;Z Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
5cv41�i. Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) /Z'tJ Z4
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQIJAL) l
Water Quantity (WQUAN'r)
Fire Life Safety (FLS)
✓� h'�U
Erosion Cntrl Permit (ERPRMT)
f-
=; Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) _ ��� C 'vim
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TOTALS:
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