12355 SW 114TH TERRACE i
ADDRESS:
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I:\records\microtlm\targels\building.doc
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CITY OF
T I G A R D CERTIFICATE OF OCCUPANCY
PERMIT#: MST1999-00263
DEVELOPMENT SERVICES DATE ISSUED: ('8/10/1999
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL.: 2S103AB-06300
ZONING: R-4.5
JURISDICTION: TIG
SITE ADDRESS: 12355 SW 114TH TERR FILE
ASUBDIVISION: WALNUT GLEN
BLOCK: LOT:021
CLASS OF WORK: NEW
TYPE. OF USE: SF
TYPE OF CONSTR: ;N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: Model Horne Temporary Use Permit #TUP1999-001r.
Final Building Inspection and Certificate of Occupancy
Approved 10/28/99 by George Steele, Building Inspector
Owner:
Ri vERSIUE HOMES
15455 NW GREENBRIER PKWY#140
E-AVERTON, OR Q7006
Phone: 50:1-545-0986
Contractor:
RIVERSIDE HOMES
15455 NW GREENBRIER PKWY
SUITE 140
BEAVERTON, OR 97006-2.115
Phone: 503-645-0986
Reg #: LIC 70065
CL
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in
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This Certificate grate's occupancy of the above referenced building or portion thereof acid
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use under which the referenced permit was
issued. �
BUILDING INSPECT BUILIAG OFFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 635-4175 Business Line: 639-4171
/ Bl1P
—Date Requ� sted i 0��s( �� AM PM BLD
Location1 35.E St4) �{ " 17af e--,� Suite MEC
Contact Person( �'`E'�/� �1�Gov Ph9 3�� -3 PLM _-
Contractor Ph SWR
UILDIN9 Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab -- ----_ __--- - — -- SIT
Post& Beam
Ext Sheath/Shear -- -. —
Int Sheath/Shear
Framing -- - - - -- ---- -------
Insulation
Drywall Nailing ------ - -- - -- -- -------- ..._
Firewall
Fire Sprinkler ----- --- - -- -- ----- -- -- ------ --- -----
Fire Alarm
Susp'd Ceiling
Roof
Misc:_ �� ------- -- ----_.
_.� ---------- ---- ---- -
PM AS
ART FAIL
- --------- ----
Post&Beam
Under Slab
Top Out -' -- -- ------ ----
Water Service
Sanitary Sewer
Rain Drains
Final
PAS ART FAIL
MECHANIC
Post& Beam -
Rough In
Gas Line ---
Smoke Dampers
PART FAIL `
i
ELECTRICAL
Service _
Rough In
UG/Slab _
Low Voltage
J Fire Alarm —
Final
PASS PART FAIL —
u SITE
J
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Fay at City Hall, 13125 SW Hall Blvd
Catch Basin ( J Please call for reinspection RF ( j Unable to inspect-no access
Fire Supply Line -
ADA
Approach/Sidewalk -- - ---- -- t - Inspectornate - � Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGAR BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
Date Requested +�( I AM PM _ BLD
Location^ �'J'a:� 1 I �- -T--eyY- Suite MEC
Contact Person � � Ph ? - `�i PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall EL IR _
Footing Access: --
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �
Slab {; ,1 - SIT
Post&Beam -
'Ext Sheath/Shear _
Int Sheath/Shear -
Fram;nv -- - - -^� ---- - -- ----------
Insulation
Drywall Nailing
rirewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- ---- --- -- — --
Roof
Misc: - - - - -- - -------
Final
PASS PART FAIL -- - _ - -- --- ._. .��---- ---- -
PLUMBING
Post&team
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final --_------- _ - --
PASS PART i'All-
MECHANICAL --
Post& Beam
Rough in
Gas tine -- —
Smoke Dampers
Final
PA6B,-RAJ?1,T-_FAIL
-` ELECTRIC! `--
r Service
Rough In •----`-
UG/Slab
Low Voltage
A
Alarm
M)PASS ART FAIL _-
SITE-
--Backfill/Grading -
Sanitary Sewer
Storm Drain f 1 Reinspodirni fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I I {'IcasP call fnr winsim(Airw f2F _ — - r:)access
Fire Supply Line Unable t0 Inspect
/y�--
ADA
Approach/Sidewalk Date / ! ` Inspector � �' Ext
Other - -
Final
PASS PART _FAIL I DO NOT REMOVE this inspection record from the job site.
Jim Funk -Walnut Green Subdivision Page 1
From: "McMullen, Eric T."<mcmullet@tvfr.com>
To: "Jim Funk (E-mail)"<;i,;,'@ci.tigard.or.us>
Date: 8/20/99 1:24PM
Subject: Walnut Green Subdivision
I did an on-site at the Walnut Green subdivision property on 114th Place
(off Walnut)on 08/19.199. The access and hydrants are adequate for
combustible construction to begin (I was asked to check for the model home
only).
The first time I ch%+cked a couple of days ago, the hydrants did riot have
water. One hydra it now has wathr, which is adequate for the model home,
however the second hydrant is completely removed fium the ground. The
second hydrant will have to be repiaced pror to construction ut any homes
after the model home.
Eric T. McMulien
Deputy , ire Marshal
^� CITY OF T!CARD MASTER PERMIT
PERMIT M MST1999-00263
DEVELOPMENT SERVICES DATE ISSUED: 8/10/99
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12355 SW 114TH TERR 021 PARCEL: 2S103Al3-WG021
SUBDIVISION: WALNUT GLEN ZONING: R-4 5
BLOCK: LOT: 021 JURISDICTION: TIG
REMARKS: model home [under a temporary use permit #TIJP1999-0010]
BUILDING _
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 20 FIRST: 1.503 sf BASEMENT: sf LEFT: 39 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 342 sf GARAGE: 5.16 sf FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: S
VALUE: $149.966 49
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: sf REAR: 23
PLUMBING —_
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAI14 DRAIN: 100 1'RAP.3:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CAI CH BASINS:
TUB/SHOWERS: 2 GARBAGE DISE: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL _
FUEL TYPES FURN c 100K: BOIL/CMP c AHP: VENT FANS: 4 CLOTHES DRYER: 1
GA FURN>=100K: 1 UNIT HEATERS: HOODS. 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS_ _ADD'L INSPECTIONS-
1000 SF OR LESS: 3 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 1 201 - 467 amp: 201 400 amp: 1stWIO SVCIFDR'. 00 SIGN/OUT LIN LT: PFR HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA ADDL BR CIW SIGNAL7PANEL IN PLANT:
MANU HMISVCIFDR: 601 • 1000 amp: 601+amps-1000v: MINOR LABEL:
1000♦amplvolf
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVCIFDR>•225 A.' >800 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL•RESTRICYED ENERGY
A.SF RESIDENTIAL __- B.COMMERCIAL •_
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR.NDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPERRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK INSTRUMENTATION. MEDICAL: OTHR:
HVAC: DATA7TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,781.71
This permit is subject to the regulations contained in the
RIVERSIDE HOMES RIVERSIDE HOME� Tigard Municipal Code,State of OR. Specialty Codes and
15450 NW GREENBRIER PKWY#140 15455 NW GREENBRIER PKWY all other applicable laws All work will be done in
BEAVERTON,OR 97006 SUITE 140 accordance with approved plans This permit will expire if
_ BEAVERTON,OR 97006-2115 work is not started within 180 days of issuance,or if the
work is suspended for more than 1S0 days ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
r� Oregon Util'!y Notification Center, Those rules are set
C [ ` ` U N A Rep 0: 1IC 70065 forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
1
Erosion 844-8444 Post/Beam Mechanical PLM/Underfloor Framing Insp Gyp Board Insp Mechanical Fina'
Footing Insp Underfloor insulation Mechanical Insp Shear Wall Insp Rain draln Insp Plumb Final
Foundation Insp Crawl Drain/Backwater Plumb Top Out Low Voltage Water Line Insp Final inspection
Slab Insp Footing/Foundation Dr; Electrical Service Gas Line Insp Appr/Sdwlk Insp Building Final
Post/Beam Structural Plm/unds:ab Insp Electrical Rouge In Insulation Insp --Electrical Final
Issued By Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next busine day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR1999 00155
13125 SW Hall Blvd.,Tigard, OR 97223 (F^;) 639-4171 DATE ISSUED: 8/10/99
PARCEL: 2S 103AB-WG021
SITE ADDRESS; 12355 SW 114TH T�7RR 021
SUBDIVISION: WALNUT GLEN ZONING: R-4.5
BLOCK: LOT: 021 _ JURISDICTION: TIG
TENANT NAME: RIVERSIDE HOMES
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for a new single family dwelling. (Model Home)
Owner: _ FEES
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140 —_�_—
BEAVERTON, OR 97006 PRMT BON 8/10/99 $2,300.00 99-317527
INSP BON 8/10/99 $35.00 99-317527
Phone: 503-645-0986 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection --1
I
ORIGINAL
J
0.7
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit ex- res. The Agency does not
guaran'.ee the accuracy of the side sewer laterals If the sewer is not located at the m asurement given, the installer
shall prospect 3 feet in all dire&ons 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 require- you to follow rules adopted
by the Jregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You ;nay obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued by: --- Permittee Signature: / 1
Call (5031639-4175 by 7:00 P.M. for an Inspectlo►r needed thu next busine1wday
CITY- OF TIGARD Residential Building Permit Application Plan Cl
1;1125 SW HALL BLVD. Additions or Alterations Recd By
Date Recd 7-a7"J!c_
TIGARD; 7R 97223 Single Family Detached or Attached (Duplex) Date to P.E. -;1_-2P. f �
V 503-639-4171
Date to DST -l� y 4
F 503-684-17297 Permit#//I50 yy_00 2G
+CkX f}1CL�s IGt 4- Print or Type caned �rG-44 -
Incomplete or illegible applications will not be accepted =w�� "'�/s� 9;ck;'f"r
4-a7 I - _ $POKE cj1ekAw DY
Name of Project Name_
Job1 ) I
=�-/- —
Address Site Address Architect Mailing Address
�. ,
Na City/State Zip Phone
r Name
Owner Mallin Address G
�. C mr,Da ss
Engineer/State Zip Phone g (.
En iMailing Address
'
-� Cit /State ip Phone
General Na �$//5� ,11� ll 1 e 1 - _ 61�- .
Contractor , % L` Describe work New 61 Addition O Alteration O Repair O
Mairing Address to be done:
Prior to permit Adclitixial Description f Work:
issuance,a copy City/State Zip Phone Z
of all licenses
are required if Oregon Const.Cont.Board Exp.Date PROJECT 1
expired in COT Llc.# VALUATION
database —Ui?-00
Mechanical Nae NEW CONSTRUCTION ONLY:
Sub- / -l Sq. Ft. House: Sq. Ft. Garagg
Contractor Mailing Address `�/`! _ ` ;C
Prior to permit
Indicate the restricted energ/installation by the electrical
subcontractor in the following areas _
issuance,a copy City/State Zip Phone - _
of all licenses Restricted Audio/Stereo
are required if Oregon Const.Cont.Board Exp.Date Energy System t Alarms
expired in COT Lic.# Installations Vacuum Irrigation
database _ System System
Plumbing Name (check all that Other:
Sub- -apply)
Contractor Mailing Address - Corner Lot YES I NO/ Flag Lot YES NO/
(check one) V check one) V
Has the Subdivision Plat recorded? N/A YES NO/
Prior to permit City/St^te Zip Phone �/
Issuance,6 copy -of all licenses are Oregon Const.Cont.Board Exp.Date
required if Lic.# I hearb acknowledge that I have read this application,that the
expired in COT Y 9 pp
database Plumbing Llc.# Exp.Date information given is correct,that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
i=
Oregon State laws.
N Name Signatunpof Owner/Agee) i Da
Electrical
Sub- Mailing Address Cont ct er-onN fihone
•-• ---�Lt�Z.
°'. Contractor
U) City/State Zip Phono
_J Prior to permit
Issuance,a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const.Cont Board Exp.Date Plat : Ma /TL#:
required If Lic.# P
expired in COT laG�� v. _ -z,;;pl 7 2, LCA Go
database Electrical Lic.# Exp.Dale Setbacks: Zone: Solar:
Electrical Supervisor Lic.# Exp.Data Engineering Approval: Planning A proval:— TIF:
isIdstsVormsWaddalt doc 11/20/98
ACKNOWLEDGEMENT OF RISK MOLD HARMLESS AGREEMENT
The purpose of the Agreement is to allow a building permit to be issued for the
construction of a model home on Lot #,2.L of the subdivision Ii
subdivision prior to the recording of the plat. lNa rut
1. The undersigned, owner of record, of said subdivision agre to hold th CityIme-
to
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Tigard harmless of any consequences that would arise by allowing move forward with the building permit and sales facility prior to recording the plat.
2. The undersignod understands and agrees not to assert any claim(s), including
litigation, against the City of Tigard, its officers, agents and employees based on the
issuance of a building pen-nit prior to plat recording.
1
By; owner/president Dated
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COMPASS CORPORATION
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