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CITY OF TIGARD BUILDING INSPECTION DIVISION MST J
24-Hour Inspection Line: 639-4175 Business Line: 639-417'i
BUP
" Date Requested_ AM PM — BLD
I-ocation___ Z�C�� �l -7 9;Pv i f- Suite _ _ MEC
Contact Person _ Ph _ PLM _
Contractor Ph SWR _
UILDING Tenant/Owner ELC _
Re all ELR
Footing Foundation Access: `1''' FPS
Ftg Drain S GN
Crawl Drain Inspection Notes: �(� -
Slab _— SIT
Post& Beam --- --
Ext Sheath/Shear
Int Sheath/Shear
Framing _--
Insulation ,r —
Drywall Nailing
Firewall
Fire Sprinkler -- - ---.---._---- _---_-_-_-�--
Fire Alarm
Susp'd Ceiling --- --
Roof
it
S PART FAIL — -- -- -- --- ---
RING
Post 8 Beam ------------ - -- - — ----------------- ---
Under Slab
TopOut ---- _.__- ------- --- --------__
Water Service
Sanitary Sewer —
Rain Drains _
Final —
PASS PART FAIL
MECHANICAL
Post& Bearn -- - ------- - --. - - ---
Rough In
GasLine --- ----._._...___------ ------ --�--
Smoke Dampers
FinalPASS PART PART FAIL
ELECTRICAL__ -- —
Service
r, Rough In - --------------
c~n UG/Slab
Low Voltage
Fire Alarm _-_---- --------__._.____.
-' Final
PASS PART FAIL __-_ _-
u SITE
Backfill/Grading - -- — - -- - -
Sanitary Sewer
Storm Drain I j Reinspectic,i fee of$_ --required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
C�-.tch Baain ( ]Please call for reinspection RE - _ I J Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL_J DO NOT REMOVE this inspection record from the job site.
I�� �� ������D CERTIFICATE OF OCCUPANCY
PERMIT#: MST97-00220
DEVELOPMENT SERVICES DATE ISSUED: u6/27/1997
133125 SW Ha!I Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102BA-03900
ZONING: R-25
JURISDICTION: TIG
SITE
SUBDIVISION: DUBLIN PARKH PL PV FILE COPY
BLOCK: LO':009
CLASS OF WORK: NEW
TYPE OF USE: SFA
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: FATH 1 1/2 OF TOWNHOUSE
Final Building Inspection and Certificate of Occupancy Approved
4/9/98 by Ken Schriendl, Building Inspector
Owner:
Phone:
Contractor:
ROSE MANOR HOMES INC
10620 SW LUCAS DR
TUALATIN, OR 97062
Phone: 452-8133
Reg #:
J
G7
U'
This Certificate grants occupancy of the above referenced building or portion thereof and
cooifirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use nder which the referenced permit was
issued.
44 k, Z_
BUILDING INSPECTOR BUILD H OFF,':IAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD MASTER F'ER IIT
DEVELOPMENT SERVICES F,ERMIT #. . . . . . . : MSTF7-0220
13125 SW Hall Blvd., Tigard,rn 97223 (503)639-4171 DATE ISSUED: 06/*7/9'7
FDARCEL-: 25102''BA--0 900
SITE ADDRESS. . . : 12030 SW 97TH F,L #F,QT
SUBDIVISION. . . . :DUBLIN FIARI: ZONING 1 -25 FID
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :012)9 ..TUR I SD I-TON:
Remarks: PATH I 1/2 OF TOWNHOUSE
------------------------------------------------------------------- BUILDING ---—--------------------...-------------------------------------
REISSUE: STORIES.......: 2 FLUOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.:NEW HEIGHT........: 23 FIRST....: 533 sf GARAGE.....: 240 sf LEFT............ 9 SMOKE DEfECTRS: Y
TYPE OF USE..k:SFA FLOOR LOAD....: 40 SECOND...: 742 ;f FR3NT .......: 20 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: I FINBSMENT: 0 sf RIGHT... ......: 0
OCCUPANCY GRF.:R3 BDRM: 3 BATH: 2 TOTAL------: 1275 sf VALUE..l: 89541 REAR..........: 17
------------------------------------------------------------------ CLU4BING -------------------------------------------------------------
SINKS.........
----------------------------------------------------SINKS.........: 1 WATER CL03ETS.. 2 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 100 TRAPS.........: 0
LAVATO°IES....: 3 DISHWASHERS... : 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWER,S...: 1 GARBAGE DISP..: 1 WATER HFATERS.: I WATER LINE ft: 100 BCKF!_W PREVNTR: 1 GREASE TRAPS..: 0
OTHEF FIXTURES: 0
-- -------—-------------- - -------- ------ --- ---- --- MECHANICgL -------------------------------------------- -----------------
FUEL TYPES----------- FURN ( 100K .. : 1 BOIL!CMP ( 3HP: 0 VENT FANS.....: 3 CLOTHES DRYERS: 1
GAS FURN `=1301, ..: 0 UNIT HEATERS..: 0 HOODo.........: 1 OT'AER UNITS...: 1
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---- --ADD'L INSPECTiONS--
1000 SF OR LESS: 1 0 200 amp..: 0 0 - ?P0 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: P
EA ADD'L 500SF.: 1 201 - 40+0 amp..: 0 201 - 400 amp..: 0 1st W/O SVC;FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps 1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ------------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
----------------------------------------------------- ELECTRICAL - RESTRICTCD ENERGY -----------------------------------------------•
A. SF RESIDENIIAL---------- ----------------- B. COMMERCI!L--------------------------------------------------------------------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PASING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: DTH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNI-:
GARAGE OPENER..: CLOCK..........: INSTRIJMENTrfTON: MEDICAL........: O1HR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS...... TOTAL # SYSTEMS: 0
Owner•: -------------------------------------Contractor: --------------------------- 10TAL FEES:$ 4?52.21;
ROSE MANOR HOMES ROSE MANOR HOMES INC This permit is subject to the regulations contained in time
G S I NW CONST 10620 SW LUCAS DR Tigard Municipal Code, State of Ore. Specialty Codes and all
10620 SW LUCAS DR TUALATIN OR 97062 other applicable laws. All work sill be done in accordance
TURLATIN OR 97062 with approved plans. This permit wil: expire if work is
Phone #: 452-8133 Phone #: 452-8133 not sta ted within 180 days of issuance, or- if the work is
Reg C.: 109868 suspended fu,- more than 180 days. ATTENTION: Oregon law
- ---------------------------------------------------------- requires you to follow rules adopted by the Oregon Utility
Notificatiun Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 -801-0080. You may obtain copies of these rules at,
direct questions to OUNC by calling (503)246-1987.
-------------------------------------------------------- REQUIRED INSPECTIONS ----------------------------------------------------- --
Erosion Control Post/Beam Meehan Mechanical Insp Gas Fireplace Water Line Insp Mechanical Final
grading Ir.specti Plm/Underfloor Low Voltage Insulation Insp Water Service In Building Final
Footing Insp Crawl Drain Plumbing Top Out Shear Wall Insp Appr/Sdwlk Insp
Foundation Insp Electrical Servi Framing Insp Gyp Board Insp Electrical Final
Post/Beam Str - Electrical tough Gas line Insp Rain Drain Insp Plumb in i
�I
ISsued . F'er,mittee Signature:
f-++++ 1 ++ ++i r++i f 1 +++ F 1 1 - i-+i--1-...f++++•f++++4-++4.++i•- ...!-++++4... ....+*++-1-4-++++
Call 61�1:9-4175 by 6:00 p. m. for an inspection needed the next business day
�ori
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER RMITCTIor4
'SW Hall Blvd., Tigard,OR 97223 (503)639-4171 FEERMI'T
PERMIT #. . . . . . . SWR97-0212
DATE ISSUED: 06/27/97
PARCEL :
SITE ADDRESS. . . : 1'030 SW 97TH PL #PVT
SUBDIVISION. . . . :DUBLIN PARK, ZONING: R--25 FID
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :009 JURISDICTION:
TENANT NAME. . . . . :
USA 1\10. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORT;. . . :NEW DWELLING UNITS. . : t
TYPE OF USE. . . . . :SF NO. OF BUILLTNGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks: PATH I 1./2 OF TOWNHOUSE
Owner-: _.___.____ _.___.__._.__..__-__.__________.__________-__---._.__.___.____.. FEES
ROSE MANOR HOMES type amol_rnt Uy date recpt
G S I NW CONST PRMT $ 2c:00. 00 DRA 06/'6/97 97-296517
10620 SW LUCAS OR INSP $ 35. 00 ORA 06/26/97 97--2'9E51-1
TUALATIN OR 9706 '
Phone #:
Contractor,:
OWNER
Ph o r e #: 22373. 00 TOTAL
Rey it. . .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 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
Ade sewer laterals. If the ewer 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 "Tap and Side Sewer" 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 952-0801-0088. You may obtain copies of r _
these rules or uestions to OUNC by calling f503)246-1987.
�- T s s t.r e d b : _wda4L t.-_ _ Per•m i t t e e S i g n a t i_r r•e :
J
F+i+++++i•++++++++++++++++++++++++i+++++++++-1+++++++++++++-F++++++++++++++++++.-1-�- r
Call 639--4175 by 6:00 p. m. for- an inspection needed the next bi.lsiness day
+++++++.++.++++++++-F++++++++++++++++++++++++++++++++++.+++++f++++++++++++++++++++
?13n Che
OF TIGARD Residential Building Permit Application Recd Bye—�_--I—b� �
-s SW F#�t : tfL
. vD. New Construction Additions or Alterations Date Rer:d 1,
LARD. OR 97223 Single Family Detached or Attached (Duplex) - Cate to P E.
3-0394171 / Date to DSTOL"-, �
:3 084-7297 (� �V Permit x h?X1-4 7 a.2.Z V
Print or Type ;,��1 J I Called_ 7
Incomplete or illegible applications will not be accepted
Name of Project Nam
i�
job " /��� �i • � -)
%ddress Site Address Architect Mailing Address
JIJllci
/Stale y7 TipE Phone
ff'1lir�t ztto rr 'c..7Lr►
OwnerMailing Address
C�,state Z p y�,-, Phone ""— Engineer Mailing Address
— ! —c�.t. "'c .•- �/ y � mss' f��� �
Name 3� C. iState uo Phone
General Describe work New Addition O Alteration O Repair O
:ontractor Mailing Atldress / to be done
"
•U 4'90 �4 ' /�Ll (/4 Add,ttenal Description of Work:
C;; iState Zip Phone
(G 4-/trr�" ct7d6,c [/,} ')-�/�3
Oregon Const.Cont. Board t.;c 0 Exp Cate
rtach Copy of `) L, l,. —
Current ( COT Busir-tss'ax or Metro a Exp. Date PROJECT
f.
L,censosVALUATION $ 4�(�/
N mo
illechanical NEW CONSTRUC t ION ONLY:
ice: �t 4'�
Sub- Mailing Address Sq. Ft. Hous Sq. Ft. Garage
.:orgtractor (}`� (�/ �i
C. ,!sta Cerner Lot YES NO Flag Lot y cS NO
Zip Pone
�.Y . {check one) !,/ c I —
' C✓1 y 7�' 1�3i' ( he one) -_1--
Oregon CCnst. Coral_ Board Lc. Exp Cate Restricted 4 Audio/Stereo ' Burglar
��h c,py or i Tax _ Energy System I Alarm_
Current CCT Business Tax or Metro a I Exo Date II1Stall3tion Garage Door HVAC
Urznsts
Name Opener , Systems
(check all that I Other'
'lambing /J/C•tlrAlil /f w4, !estncted-!2!Lqy
ply)
Mailing Mang Aodress tra
II the electrical subcon .tor utre for all TYEES-IN O
'.,ontractor , f 5/6'Z, s t,L< r 7- installatietts?
j State Z.p I Phone Has the Subdivision Plat recorded'' N/A I YES I NO
f lir. ,' iZ ;3i?
Oregon Co st Cont Board Lie.0 I Exp Date Reissue of NIS74 —'--1' —'
-Inch Cepy of Sol?r CCmpliance
Currerc Piumoir.g L:c. ! Exp. Date (Calculation Attached)
�) Licenses I hearby acknowledge that I have read this application, that the
i I COT Eus,ress-ax or Metro a Exp Date formation given is correct. that I am the owner.or authorized
agent of the owrer, and that plans submitted are in compliance
- with Ore on State ws
� Nage _
c� - ectrical , Si a of Owfte Agent Date
Sub- Manirg Adoress `t 7
Contact Person Npme Phone 9
ontractor C' �If•,� �jz,, orf �!1_�
C gate Zip ++ ""one FOR OFFICE USE O
7i I171
Plat;$-
p/TL4:
regcn „onst. Cont. Board L c 0 Eio D to �(�� �-� V �5Z �� _�,� p�lJ
-ach Copy of I Q ✓ 16'7 �f Z�-��7 Setbacks _
FFF--- I Solar.
•;utrent Electrical L;c. >M °xp.Da'a : -", Znne i r
censes ) LS�� _jo 4-177 Frigjnee r� bio al: Planning Approval: TIF
CCT 3,s,ness Tax or Metro a + Exp pate a ` b
iaafapp doc drat) 1/97
� f:�" �'r t fT, M% r"J!"C.(°.-1 , r,�5�1.,,`��f11/ �� ►�ttf.��, 'D�
Ppm,r2i1t # Account Ducriution Amount Amt. Pd. EL4 Qug
yr &7-y,??U MST Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT)
State Tax (TAX)
Bldg: Ao,
Plumb: 7'
Ntech: 2 0 3
ELC/ELR: �• ��
Plan Check
MST: (BUPPLN) Ali , IJ-" V 550 l/, S�
Plumb: (PLMPLN)
Mech: (MECPLN) �3-
CDC Review (LANDUS) p,
St,kf 7,ULI-Sewer Connection (SWUSA) �2�a v� — 2L1/
Sewer Inspection (SWINSP) 3��- 3 )_
Parks Dev Charge (PKSDC) OSe),
Residential TIF (T!F-R) 1,570 y v
Mass Transit TIF (TIF-MT) / 2p /
Water Quality (WQUAL)
Water Quantity (WQUANT) / Ua
Erosion Control Permit (ERPKMT) U elu
Erosion Planck/USA (ERPLAN)
C
w Erosion PlanckJCUT (EROSN) �� r
Fire Life Safety - (FLS) _
TOTALS:
� 3
�� �1`3CD&C (dst) 119-1
503-225-0933 MASCORD DESIGN ASSOC 523 P03 NJ 17 '97 07:17
•/IWO 11 v�.1�..1.. .e v u....�... ....._ •.........
'7900 4006
ROSE MANOR HOMES, LTD,
IPH.I 452-8133
15' PRIVATE CITY OF TIGARD
DUP.LIN PARK
LOT 9 • 12030 S.W. 97 fH PLACE
LOT 10 . 12042 S.W. 97 fM PI ACE
�.
• � �• NOTE
GRAVE/ DMVEWAY ENTRANCE
PER ERO=N CONTROL
G
T
LOT 9 .06.
1 I
M FLOOR . -
N 1 "MAIN FLOOR
I � /
I
9'•4j` GARAGE
EL.066.5' b / -91f
GARAGE
d EL.=166,6 /
_ I A•cow.
OO MV AT
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A.
CONE. ,O
1}LMyEWAY i
LYAr I Woo►.NJ /' / hQ
�ryr�0 S 06.
s '' LOT 10
J•'
s (2,560 S0. FT,)06,
/
0
7 T17" f
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91 T \rt btir
LD
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ORIGINAL.
06/17/97 MaF7
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IS NOT LIARL!FOR 714F t.CCURACY Of TLS
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ALL nrI Cello 70hil,WAUUNG ANY FILL,,A=ON LLI SLTI ALC WORM 0WNIp4
OC ANY OOtI411Al RELD MMFICAIKPO
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