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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - —
� BUP
Date Requested_ -- ----___hM `—__ BLD
Location ';�C L4?" 27 r'ti d:2 Suite _ MEC
Contact Person _ _ Ph _ PLM
Contractor _ Ph _ SWR --7 T1s✓ ��
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: /
Foundation Zc� � FPS
Cr Drain -
Crawl Drain Inspection Notes: SGN —
Slab SIT
Post& Beam —
Ext Sheath/Shear
Int Sheath/Shear _
Framing S
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
mise: __-
Final
PASS PART FAIL
PLUMBING
Post& Beam
Under Slab
Top Out --- - —--- --- ----
Water Service
ni ary Sew - - -- - -- ------
Ram rains
7AS PART FAIL
CHANICAL --------� !— ----- - - _ -
Post&Beam
Rough In
Gas Line ----- ----------- ----- -- - -
Smoke Dampers -
Final - ��---- --
PASS PART rAIL
ELECTRICAL - - --��- --- -----
Service
rt Rough In - -_---- --- - ___ -
v UG/Slab
Low Voltage I
Fire Alarm _
-� Final
m PASS PART FAIL _
SITE
-� Backfill/Grading --- - -- - - - -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RF _ ( ]Unable to insp3ct- no access
AnA
Approach/Sidewalk
Other Date I C� CIInspector c� Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
CERTIFICATE OF OCCUPANCY
CITY OF T I GA R D
PERMIT#: MST97-00221
DEVELOPMENT SERVICES DATE ISSUED: 06/27/1997
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 25102BA-04000
ZONIN 3: R-25
JURISDICTION: TIG
SITE ADDRESS: 12042 SW 97 TH PL PVT
SUBDIVISION: DUBLIN PARK FILE
COPY
BLOCK: LOT:010
CLASS OF WORK: NEW
TYPE OF USE: SFA
TYPE OF CONSTR- 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: PATH 11/2 OF TOWNHOUSE
Final Building Inspection and Certificate of Occupancy Approved
9/4/97 by Ken Scnriendl, Building Inspector
Owner:
Phone:
Contractor:
ROSE MANOR HOMES INC
10620 SW LUCAS DR
TUALATIN, OR 97062
Phone: 452-8133
Reg #:
R
r
v:
J
C.7
LJ
This Certificate grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the roup, occupancy, and use Ilder which the referenced permit was
issued.
BUILDING INSPECTOR BUILDIN(' OFFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES F,ERMIT #. . . . . . . : MST97-02'21.
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 06/ 7/97
PARCEL: `S 102BA--04000
SITE ADDRESS. . . : 1204'2: SW 97 TH PL 11F,V"f
SUBDIVISION. . . . :DUBLIN PARK ZONING: R-25 F'D
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :010 JURISDICTION:
Remarks: PATH I 1/2 OF TOWN10SE
------------------------------------------------------------ BUILDING --------------------------------- ---------------------
REISSUE: STORIES.......: 2 FLOOR AREAS--------- BASEMENT...: 0 sf REQUIRED SETBACKS----- 'EQUIRED-------------
CLASS OF WORK.:NEW HEIGHT........: 23 FIRST....: 533 sf GARAGE.....: 240 sf LEFT..........: 0 jMDIE DETECTRS: Y
TYPE OF USE...4tFA FLOOR LOAD....: 40 SECOND .: 742 sf FRONT.........: 20 PARKING SPACES: 1
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT........ : 11
OCCUPANCY GRP. :R3 BDRM: 3 BATH: 2 TOTAL------: 1275 sf VALUE..$: 89541 REAR..........: 17
-------------------------
-------------------------------- PLUMBING ------------------------•--•-------------------------------------
SINKS.........: 1 WATER CLOSETS.: 2 WASHING MACK..: 1 LAUNDRI TRAYS.: 0 RAIN DRAIN ft: 100 TRAPS.........: 0
LAVATORIES....: 3 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: 1 GARBAGE DISP..: 1 WATER HEATERS.: i WATER LINE. ft: 100 BCKFLW PREVNTR: i GREASE TRAPS..: e
OTHER FIXTURES: 0
----------------------------•---------------------------------- MECHANICAL ----------------------------------------------------------------
FUEL TYPES---------- FURN 1100K ..: 1 BOIL/CMP ( 3HP: 0 VENT FANS—-: 3 CLOTHES DRYERS: 1
GAS FURN )=100K ..: 0 WIT HEATERS..: 0 HOODS.........: 1 OTHF-R UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1
- -- -------------- ELECTRICAL ------ ----------------------------------------------------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER----- --TEMP SRVC/FEEDERS-- ---BRAt -'+ CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 1 0 -- 200 amp..: 0 0 - 200 amp..: 0 W/SVC W SDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 1 201 - 400 amp..: 0 281 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 40i - 600 amp..: 0 401 - 600 amp..: 0 EP ADDL BR CIR: 0 SIGNAL/PAWL...: 0 IN PLANT......: 0
MAIC 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 -- RESTRICTED ENERGY ------------------.-._---------------------------------
A. SF RESIDENTIAL----------------------------- B. COMMERCIAL------------------------------------------------------------------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM-- : INTERCCM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM.. : OTH: :: X BOILER.........: HVAC........... : LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL R SYSTEMS: 0
Owner: -------------------------------------Contractor: ---------------------•---------- TOTAL FEES:$ 4252.26
ROSE MANOR HOMES ROSE M NOh HOMES INC This permit is subject to the regulations contained in the
G S I NW CONST 10620 SW LUCAS DR Tigard Municipal Code, State of Ore. Specialty Codes and all
10620 SW LUCAS DR. iUALATIN OR 97062 other applicable laws. All work will be done in accordance
TUALATIN OR 97062 with approved plans. Tnis permit will expire if work is
Phone N: 452-8133 Phone #: 452-8133 not started within 180 days of issuance, or if the work is
Reg C.: 109868 suspended for more than 180 days. 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 952-001-0090. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
n, ---- REQUIRED INSPECTIONS ------------------------------- ------------------------
rl" Erosion Control Post/Beam Mechan Mechanical Insp Gas Line Insp Water Line Insp Building Final
Grading Inspecti Ple/Underfloor Low Voltage Insulation Insp Appr/Sdwlk Insp
Footing Insp Crawl Drain Plumbing Top Out Shear Wall Insp Electrical Final
Foundation Insp Electrical Servi Framing Ir:sp Gyp Board Insp Plumb Final
Post/Beam Str Electrical Rough fireplace Insp Pain Drain Insp Mecha"e)l Final _
Ts _r-red Permittee Signat ure
y :
++t+a+++ ++ ++++++++1 ++-i +•+++++-++++++++++•1•+++-1-++++++++++++ r+•F++-1 +-4-+++++++++.a
Call 639--4170 by 6:00 p. m. for an inspection needed the next business day
r
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
12125 SW Hall Blvd., Tigard,Ok 97223 (50^1 639-4171 PERMIT
PERMIT #. . . . . . . : CWR97-02 1?1'
DATE ISSUED: 06/27/97
PARCEL: 25102— 04000
SI E ADDRESS. . . : 1 '04L SW 97 TH PL #PVT
SUBDIVISION. . . . :DUBLIN PARK ZONING: R-25 PD
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :O1O JURISDICTION:
..TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : i
l YPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYP,E. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks : Pf1TH 1 1/11. OF TOWNHOUSE
Owner,: __._.__.-----____.___... _.___..._____.___.__________._.._..__.--.-•----......._._.._ FEES
R95E MANUR HOMES type amount by date recpt
G S I NW CONST PRMT $ 2200. 00 DRA 06/26/97 97-296518
tO62O SW LUCAS DR INSP 35. dt?� Df?f1 06/26/c.7 97--296518
TUALATIN OR 97062:
Phone #:
Cont V'aCt ar : ------------------•--•----------
OWNERC
Phone #: f 2235. 00 TOTAL
Reg #. . :
------- REQUIRED INSPECTIONS ------
This Applicant agrees to comply with all the rules and regulations Sewer Inspaction
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the i
permit expires. The Agincy 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 frac
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" permit and the Agency will install a lateral.
ATTFNTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification r.'enter. Those rules are set forth in OAR
952--801-0010 through OAR 952-000?-0080. You may obtain copies of
N these rules or dir t questions to ME by calling (503)246-1987.
1. is 1-ted b ") � __-_-_- Permitt e e S i g n a t u r e :
++++i +++++•+t-++-r"+++++++++++++++++++++++++4•+++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for, an inspection needed the next business day
+-++++++++++++++++++++++++•r•+++++A++++++++++++++++++++++-f•++++++++++++++++++++++++
Plan CheckA
-Y OF TIGARD Residential Building Permit Application Recd By
35 SW HALL BLVD. New Construction Additions or Alterations Date Recd
713ARD, (I?z 97223 Single Family Detached or Attached (Duplex) Date!oPE L_?-i<�
403•-639-4171 Date to DST % `/3— 157 7
'03-684-7297 Permit s lvl sF9�-O,2 Z/
Print or Type Caned
Incomplete or illegible applications will not be accepter:
Name of Protect Nae
.lob �L{�x V' A'iw/� � )P
AddressSte Address Architect M ding Address
v () / L Y Ste' 9 7"�` �' v
rSX tate Zip Phone
e ��t'ivet yy4►� �� �✓o�
yr. stems
Owner Mailing Address N e
-)q l �k c A ' PA Oc tiG�JI
State Z;p Phone
Engineer Mailing Address
C. r _
I lu�1�aT,.ti, 64 r ���� y5-,9- F133 s--- /ea k?
i Name
tyr tate Zip Phone
General �
S ' n "vX S i L c" Describe work New Addition O Alteration O Repan O
Contractor � ding Address to be done.
c_)"Q Sw i4 ac p Ur2 Additional Description of`Ncrk:
c, estate Zio Phone
a , ✓t TcE 2 _a/3
Oregon Const. Gont. Board Lr.A Exp. Date
/
•%"ach Copy of U C ` L'o / -I -y 7
Current COT Business Tax or Metros Exp Date PROJECT
Licenses VALUATION
Name
,MechanicalNEW CONSTRUCTION ONLY:
~ Sq. Ft. House. S Ft. Garage
Sub- Mailing Address —�"• / „ _ .. q• t9
/ d � I-r_ "! c ,
:contractor 271,.25 Corner, Corner Lot YES T NO Flag Lot YES NO
C. ,Sia Zip �r Phonq (check one) (check one)
Oregon 'onst.::ont. Hoard Loac.x Exo Date Restncted Audio/Stereo Burglar
+ttich Copy of -_L' &';)( I Energy �_�System Alarm _
Current COT Business Tax or Metro 0 Exp Date I Installation Garage Door HVA_C
Licenses Opener �' Systems
Name (check all that Other
Plumbing / /t/� -r <C f L - apply)
Sub- Mailing Address 'NII the electrical subcontractor wire for all YES NO
ContractorL°jj/vt) p L�t r /� I restncted energy installations
C, istate Zip II Phone Has the Subdivision Plat recoided'� N/A I YE� I NO
,pc 04 �1d,rt 4c�-731 Z � I I
� ✓
Oregon Cant Cont. Board Lic 0 I Exp. Date Reisst:e of MST Solar Cr_mpliance
t.eh Copy of (Calculation Attached)
Curtent P+umGrng Lic.a« I Exp. Date I I hearby acknowledge that I have read this application, that the
Llernses —_ information given is con ect. that I am the owner or authonzed
COT E16siness Tax or Metros Exp. Date
�- I I agent of the owner, am.4 that plans subinittec'.- a in compliance
Narre with Oregon State laws
Electrical J^ S'�fr gent Date
-u cu �>r�QCs �p
Sub- M ling ACpr�y '0'4?t - i C tact Person Name Phone N
ontractor JJI �� r� y,7i yv
C Phone FOR FICE USE O LY:
- 'e173 Plate (� � " Map/TLl
Oregon Ccrst. Cont. Board L c x Exo Date „2,5/O Z- /q-G q6 C,d
•ach Copy of _C'r' 1 V7 Irl 10--11-17 Setbacks: Zone. Solar:
-urrent I E ec:ncai LSC. 0 } Exp. Date��
_.tenses
Engir�een g Appro �l I Planning Approval. TIF
COT Business Tax or Mitro a Exp Date �U r�wi
( `17
I. 2 /G /1 31 - g I; fapp.doc(dat) 1/67
Permit # Account Descrip 4n Amount Amt. Pd, Bal Due
Mst0 0Az I MST Permit (BUILD) • v3 _ r 41,
Plumb. Permit (PLUME,) /'9)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT) 17)
State Tax (TAX) y0-
Bldg-
Plumb-
Mech.
0•Bldg:Plumb:Mech: 3
ELC/ELR: S
Plan Check
MST. (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN) _/o• =3 �'l0.
CDC Review (LANDUS) I/ 0
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Sewer Inspection (SWINSP) 3 j� ' 7 '1 i
Parks Dev Charge (PKSDC) /C- 7l % ✓�'0 S-2)
Residential TIF (TIF-R) / 7G• ! IS�U,
Mass Transit TIF (TIF-MT)
Water Ouality (WQUAL)
Water Quantity (WQUANT) y✓ /uU
Erosion Control Permit (ERPRMI) U40
Erosion Planck/USA (ERPLAN) 13 13
Erosion Planck/1'01 (EROSN)
Fire Life Safety (FLS) _
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0 J'I AL.. (MOUN1 PAID
ALAN MASCORD DESIGN ASSOC. , L225-9161
1305 N.W. 18TH AVENUE
PORTLAND, OREGON 97209 (503)
J]
................................................................................
SOLAR CALCULATIONS FOR:
::ROSE MANOR HOMES LTD.
::LOTS 9 & 1-0
;;DUBLIN PARK
::CITY OF TIGARD
................................................................................
................................................................................
•••••••••••••••:••••GIVEN DESIGN VALUES :::::::::::::::::::::
................................................................................
::NIS LOT DIMENSION. . . . . . . . . . . . . . . . . . 37 . 85
;;AVERAGE FRONT P . L. GRADE ELEV. . . . . . 98 . 5
::AVERAGE REAR P.L. GRADE ELEV. . . . . . . 9P . 5
;;FINISH FLOOR ELEV:.TION. . . . . . . . . . . . . 100
::HEIGHT OF RIDGE ABOVE FF. . . . . . . . . . . 24 . 1.6
::HEIGHT OF EAVE ABOVE FF. . . . . . . . . . . . 0
::ROOF RISE PER 12 RUN. . . . . . . . . . . . . . . 8
:DOES RIDGE RUN NIS . . . . . . . . . . . . . . . . . Y
::SETBACK DISTANCE FOR SHADE POINT. . . 1.6 . 16
................................................................................
................................................................................
:CALCULATED VALUES :
ADJUSTED NIS LOT DIMENSION . . 37 , P5
RIDGE ELEVATION. . . . . . . . . . . . . . . . . . . . 124 . 16
F.AVE ELEVATION. . . . . . . . . . . . . . . . . . . . . 100
ADDITION TO S . P .H. FOR NIS RIDGE. . . 3
ADDITION TO S . P. H. FOR LOT SLOPE. . . 0
.S
OH161
* ALLOWED SHADE POIN; ELEVATION. . . . . . . ..1 . 894
NALACTUAL HADE POINT ELEVATION. . . . . . 1.6
.... ::....................................................................... ......
..............................................I........................... .
J
BUILDING COMPLIES WITH SOLAR C'ODE . . .
* BASED ON FORMULA: H = ( ( (2 * D) - N + 150) / 5) + ADJUSTMENTS
WHERE H = MAX . ALLOWED HGT. OF SHADE POINT
D = DISTANCE BETWEEN SHADE POINT & NORTH LOT LINE
N = NORT14 SOUTH LOT DIMENSION (90 ' MAX. )
ADJUSTMENTS = FOR RIDGE DIRECTION NIS AND SLOPE OF LOT
0111
' 503-225-0933 MASCORD DESIGN ASSOC 523 F'03 JUN 17 '97 07:17
n
A-
1,006
6� I
O qoc-) "l ROSE MANOR HOMES, LTD.
(PH.) 452-el33
13' PRIVATE CITY OF TIGARD
\� S.O.E. DUBLIN PARK
LOT 9 • 12030 S.W. 97TH PLACE
h \� .OT 10 - 12042 S.W. 97TH PLACE
NOTE.
X14 ,� \�s �`�`\ GRAVEL ORI VEWAY ENTRANCE
I \ps o PER EROSION CONTROL
w � 5536?•F 1�
LOT 9 s. ��I)�1Tf
\\ \ps'• �� y 6 L5
( 3,008 S0. FT.)
rill .\`` T\\\ 3000<-�
\
/f
M E.101 FLOOR
p
, MAIN FLOOR
f
1
9'•421
GARAGE,
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s 2,360
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