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10635 SW LADY MARION DRIVE s M } o I w cn r ns CL 3 d :y �t o i i I i 1 I 7 4 10635 SW Lady Marion Drive CITY OF TIGARD BUILDING INSPECTION DIVISION Msr �"�� 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 —�-- BUP Date Requested._ 4/ 7 —AM— PM BLU -- _ ocatlon 3� �� G ��r,�-., _ Suite _ MEC Conta^t Person Ph PLM Contractor_ --- _-- _ Ph SWR _ --_.—__— �BUILDING TFrantinwnerELC Retaining Wall '_ -- - -- ELR Footing Access: -- Foundation FPS Ftg Drain Crawl Drain Inspection Notes SGN Slab -- _— -- ------- — - - -- --- SIT Post&Beam --- Ext Sheath/Shear Int Sheath/Shear --- — Framing ------------- --------- Insr'anon -- ---- ----- --—.__.—. Drywall Nailing Firewall Fire Sprinkler Fire Alarm / Susp'd C ailing --- —�N�f�----- --- �''`� S ---- - ---- — Roof Misc. — Final PASS PART FAIL - -------- ---- --- ----------------- PLUMBING Post& Beam Under Slab Top Out Water Service Sanitai y Sewer —� Rain Drains /Z� ��- __— Final I PASS PORT FAIL_ MECHANICAL Dost& Beam - — --- -- -�— ------ ---- -- Rough In Gras Line - - -- - --- --- --_—_— --- Smoke Dampers Final --- — - -- ---- --. PASS PART FAIL SerVICI' RoughIn -- -- --- ----------------_.—...----- -- UG/Slab _ �� --- --- — —-------- -- Low Voltage Fire Alarm -----------__—.-- F' PASS �IPRT r4.IL —_� —. --_--- -- --- ---- ---- Sanitary Sewer Storm Drain I 1 r�elnspertinn fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin I Please call for reinspection RE— — _ ( ( Unable to inspect-no access Fire Supply Line - ADA ? Approach/Sidewalk Datc ! ��✓ Inspector /��L..�_ Ext Other — Final — PASS PART FAIL. DO NOT REMOVE this inspect-on record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST'a- 24-Hour Inspection Line: 639••4175 Business Line: 639-4171 --- BUP _ --__,—_—Date Requested_ .. ----AM PM - BLD Location �� 3� S� G � �i••, __ Suite _ MEC _ Contact Person _— Ph PLM Contractor _ Ph SWR BUILD N om— - Tenant/Owner ELC — _ Retaining Wall ^— ELR Footing Access: - Foundation FPS Ftg Drain --- -- - Crawl Drain Inspection Notes `GN Slab ---__- --------- - SIT Post& Rea;n -- --- -- Ext Sheath/Shear Int Sheath/Shear --` --------- - Framing Insulation - -- Drywall Nailing Firewall -- -�--- -- - - -Fire Sprinkler Sprinkler Fire Alarm - Susp'd Ceiling Roof ----- Misc: A PART FAIL Post&Beam - --- - ---- -- Under Slab Top Out — Water Service Sanitary Sewer Rain Drains SS-_ RT FAIT_ ---- Post& Hearn - Rorigh In Gas Line - -- - Smoke Dampers OWART FAIL AS RICAL. -- - - - - ------ -- -— Service Rough In UG/Slab Looe Voltage - Fire Alarm Final PASS PART FAIL SITE Backfill/Grading - - — ------ sanitary Sewer Storm Drain ]Reinspection fee of$ required before next inspection Pay at City Hall, 1312E SW Hall Bled Catch Basin Please call for reins e�tion RE: Fire Supply Line I ] P ___._ —__-_. I ] Unable to inspect-no access ADA --* Approach/Sldewalk l Other Date Inspector_ �I __ Ext Final I PASS PART FAIL DO NOT REMOVE this inspection iecord from the job site. CITYITY O F T I G A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00357 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUE[,: 08115/2001 PARCEL: 2S 11 ODA-07800 SITE ADDRESS: 10635 SW LADY MARION DR SUBDIVISION: ERICKSON HEIGHTS ZU,4ING: R-3.5 _ BLOCK: LOT: 039 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 2730100000 1672 SW WILLAMLTTE FALLS DR 5PCT CTR 08/15/2001 $2 90 27200100000 \NEST LiNN, OR 91062 - Tota! $39.15 Phone 1: Contractors ;MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1. 503-630-5532 Final Inspection Reg#: LIC 597.1 PLM 11717 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is 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 i►, OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: —- ,•`, t. ___ Permittee Signature: Cal! (503) 639-4175 by 7:00 P.M.for an inspection needed the next business day ,'IS7-,7 f n - o X57? Plumbing Permit Application City of Tigard 7L14recetved. ��1J/ Permitno.:^,pAddress: 13125 SW Hall Bled. Tigard, OR 97223 r permit no.: Building permitno.: 1 City oJTlgnrd i'l lone: (503.1 639-4171 Proect/aPPI.no.. , Expiredate: Fax. 1503) 598-1960 Date issued; By: -' %, Receipt no.: Lard use approval: _ Case file no I Payment type O &2 family dwell;ng or accesr•ory O Corr,mercial/industrial 0 Multi-family J Tenant irnpmvement New constnicrron 0 Addition/alteration/replacement i]Food service J Other. I Job address: _l.L�� 1Ducri tion Fix ems. Total 111g. no,:— ` I Suite no.: ew 1-ani 2-family dMeWng only; faxr,,ap/taxlol/accountno.: - (Includes 100 ft.for etechutility connection) ---- SFR(1) bath Lot: Block: (2)Subdivision: STR bath _.___ Projectmune: 2/ Se z,; - SFR 01 hath — _ 4 CiLy/county: .I� 2 2 — ac additions ba kitchen - - Description and location of work;on premises: S �t7n 1 4 /r' i filtoutWtica: _Catch hasinAar.a drain Est.date of eom lerion/inspection• l5r well, each I neArenc. Bruin "- Min rain(no.lin. ft) "..anti acturcd home utilities `- Business name: ;� - ti/ - lr Tti'� _ anhuies Business -E—in t.rain cordrector City Fy^ kca�r�/ State a LZ1P: G'i G'z — anttary sewer(no. lin.ft.) Phone: kp. :3v•i!' e Faxa" C-mail: Storm sewer(no.lin.ft.) _ —�- -� Water service(no. lin. ft.i — CCB no.://7/y Plumb.bus.reg no: y`y ~3 City/metro tic.nit.: -- -- Fixture or Item: F_-'— - _ i sorption valve Contractor's representative siRttature�% _._ Backflowreventer Print njoe ., .e J,._,' Dar,: '/ �� $ac wk atervalve - Hasins/lavatory r ' Z`(o, es washer Name /.,;v C ! •c fc Dis'hw Address, asher r 7/J' City: L S' �rc�,�: StateC./"' ,ZI--r p:,7/"Z� nt�n in fountains) - phone: 'p� tv�c: ye' Fax: << !/t' E-mail: N- Allyint fT,;UirF'sewer ca ., Floor dra,n's/ oor sin►chub ----- -- amc(print): disposal � Mailing address: �, � Garbagel City: Sate Z1P: T (lose bibb r Ice maker Phone. Fax.: E-mail: _ _ nterce tor/grease!ra —__ Crwner installalion/residential msintenanoe only: The a:nial installation mer(s) � will he made by me q to lntenance and repair made by my reg'ilar Roof drain(cnmmercfal) -- eniplor. :on the p en I w as per ORS CI•pter 4,7. rn (s), bail (s), a✓s(s) t twtters si nature: Date: Hum _ Tu s/shower/shower an Name. Lrinal _ Address: `- "- ater c Water heater ZIP" _ "Mier: -- -- Plionc: Fax: Nn'A Judodkdom accept crnllt curds please cdi iumdirt!an tui mnry Mrarnmlontitlnimurn fee................ Notice:This permit application U visa tJ bet, ere cxpirc±if a pemtit is not obtained I'lun rrvirw(Rt 96) $ cr•du and numDa _(� , State surcharge(8%) ....$ • 9 D ---J— -----_._ with in 180 days after it hay been — P - - — -- ecce ted as complete. COT 1L ............ . ........ Nu•r:a of cu3'older s+tha::n an crte�i nerd -'� P S ardholdet u;nsiure ---_— Amaunt "C-MIf•(&MCCH qi V ELECT ICAL CITY OF TIG,ARD RESTRICTED EN RIGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00074 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/27/01 SITE ADDRESS: 10635 SW LADY MARION DR PARCEL: 2S110DA-0780( SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 039 JURISDICTION: TIG Proiect Dessrigtion: A. RESIDENTIAL _ _ B.COMMERCIAL___ AUDIO & STERE_O: AUDIO & STEREO: INTERCOM & PAGING E'URGLAR -ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL_: INSTRUMFNTATI JN: OTHER: TOTAL#OF SYSTEMS_ _ Owner: Contractor: RENAISSANCE CUSTOM FIOMES GREENLINE INC 1672 SW WILLAMETTE FALLS DR PO BOX 230755 WEST I_INN, OR 97062 T-IGARD. OR 97223 Phone: Phone: 968-19(8 Reg #: LIC 103033 ELE 34-397CL FEES _ Required Inspections Type By Date Amount Receipt _ Low Voltage InFpection PRMT CTS, 3/27/01 $75.00 2720010000 Elect'I Final 5PCT CTR 3/27/01 $6.00 2720010000 Total $81.00 This Permit is issued subject to the regulations contai,:ed in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is 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 OAP. 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 2.46-1987 _ Issued by TTL, Permittee Signature _ OWNER INSTALLATION_ONLY The installation is being n6 property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: - _ —• -` — DATE: Z 7 n I CONTRACTOR INSTALLATION SIGNATURE Y— SIGNATURE OF SUPR. ELEC'N LICENSE NO: ---- -- Call 639-4175 by r:00 P.M. for an inspection needed the next business day Electrical Permit Application Date received: �J ;L' 6 Permit no.flLa4D/-00S City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ey: pt no.: Phone: (503) 639-4171 - - ----- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 5,11111 WNTIMM I &t:2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New crmsLiUt-tirin U AdcLtion/alteration/replacement U Other: _ U Partial Joh address: Q0 JTa, map/tax lot/account no.: Lot: Block: Subdivision: Project name: Description and location of work on premises: Estimated date of completion/inspection: I ' Job no: Ifs• Max Business name: L N& Dricriptfon � Ory (ca.) total no.loco �,,st.� Nei,residential-sinple or multi famih per Address: 1-4AY a SIS dwellingunit.Inclurim attached garage. City: State: ZIP:41111W Serviceincluded: Phone. Fa =-mail: 1000 sq.ft.or leas —_-_ — _4 - Each additional 50(1 sq.ft.or orlion thereof CCA no.: �3Q� Elec.bus. lic,no: L Limited ener y,residential _2 City/oletro lic.tit, — Limiledenergy,non-residential 2 Each manufactured home or modular dwelling Si nature of sit en r,mg electrician(required) Date Service and/or feeder — 2 elect.name(pool I.icensc no. Services or feeders-Installation. Sup. alteration or relocation: 200 amps or less 2 Name(print): �� GV �, 201 amps to 600 amps 2 — 401 amps to 60(1 ammo 2 Mailing address:_ ( S 601 amps to I(xN)amps - z City: LV titate: IIP. Over 1000 amps or volts 2 Phone: -ION I fax: Email: Re-onnectonly I Owner installation:The 'istallation is being made on property I own I Imporary services or feeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration.or relocation- ORS 447,455,479, n 7 1 100 amps or less 2 201 atop!to 400:mps 2 Owner's signature: Date: 3 _� Q� 401 to600r:o s 2 Branch circuits-new,aller.-oion, or erten,Ion per panel: Name: ----___ _.-_- ___ A. Fce:or branch circuits with purchase of Address: service or feeder fee,each In inch circ-it 2 City: Slate: ZIP: B. Fee for branch circuits wilho.t'purchase -Phone �Fa T. F-mail: of se'vice or fester fee,first aranch circuit: 2 -- - F.ach additional branch circuit: ' Misc.(.Service or feeder not Included): U Service over 225 amps, ,1,1,1; U Health-earn fncility Each pump or irrigation circle - 2 — U Service over 320 amps-rating of 1<&2 U Hazardous location Each signor outline lighting fomilydwellings U Building over 10.000 square feet four of Cignal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or exlension'r U Building over three stories U Feeders.4(Nl amps or more *Description: — U Occupant land over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable in any of the alcove: — U Egres0ightingplan U Other. Per inspection Submit_sets of plans with any of the above. Investigation fee — The above are not applicable to tengcorary eonalruction service. Other Nm all jurlmiictions accept credit cordo,please call iudadlcnon rot more for Inmation Notice:'this memoir application Permit fee.....................$ - U Visa U MasterCard expires if a permit is not obtained Plan review(at ____ %) Credit card mother __ __�— within 180 days alter it has been State surcharge(R%,) .... Esplrer accepted as complete. TOTAL ....................... Name of cerdholder ass own on credit ciiF S Cardholder signature Amount 44n-4615(61MICOM) i MASTER PERMIT CITY OF T I GA R D PERMIT#: MST2000-00458 DEVELOPMENT SERVICES DATE ISSUED: 1116/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 635-4171 SITE ADDRESS: 0635 SW LADY MARIO—k DR PARCEL: 2S110DA-07800 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 039 JURISDICTICN: TIG REMARKS: Construct new single family detached residence. BUILDING REISSUE. STORIES. FLOOR AREAS -- _REO11'RED SETBACKS REQUIRED CLASS OF WORK: NFW HEIGHT: 21 FIRST: 1.439 of BASEMENT: el —LEFT: 11 S, OKE DETECTORS: Y TYPE OF USE: 5F FLOOR LOAD: 40 SECOND: 125: of GARAGE.: 645 of FRONT. 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: of RIGHT: 5 VALUE: $246.87500 OCCUPANCY GRP: R.1 9DRW 4 BATH: I TOTAL: 16 9 1 00 al REAR: 11C _ PLUMBING SINKS: 1 WATFR CLOSETS: 3 NASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN: IOn TRAPS: LAVAT"RIES: DISHWASHERS: I F'-OOR DRAINS. SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUB/SHOWERS: 3 GARBAGE DISP: I 'NATER HEAT ERS I WATER LINES: 100 BCKFLW PR "NTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP,OHP: VENT FANS: 5 CLOTHES DRYER: I SAS FURN>%100K: I UNIT HEATERS. HOODS I OTHER UNITS: 1 MAX INP. blu FLOOR rURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS M1' IELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 1 0 - 200 amp0 - 200 amp. WISVC OR FDR: I PUMPIIRRIGATION. PER INSPECTION EA ADD'L 500SF: 5 201 400 amp. 201 400 amp: tet WIO SVCIFDR. 00 SIGWOUT LIN LT: PER HOUR LIMITED ENERGY: 401 600 amp: 401 - 600 amp' FA ADDL BR GR, SIGNAUPANEL: IN PLANT: MANU HM/SVC/FDR: 601 1000 amp: 601-amps-1000v: MINOR LABEL: 1000-amplvoll: PLAN REVIEW SECTION Rernprled only: r--4 RES UNITS: SVCIFDR>-225 A.: >600 V NOMINAL: CLS AREAISPC UCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO R STEREO: VACUUM SYSTEM. AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OP,DOOR LNDSC LT: BURGLAR ALARM: OTH BOILER. HVAC: LAND3CAPC!IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: IN3TPUME.NTATION. MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CAL LS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL. FEES: $ 6,788.78 This permit Is subject to the regulations contained in the RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES 1672 SW WILLAMETTE FALLS DR 1672.WILLAMETTE FALLS DR Tigard t'uniccCode,State of OR Specialty Codes and all otherrapplicable laws All work will be done in WEST LINN,OR 97062 WEST LINN,OR 970-8 accordance with approved plans This pen-,Tit will expired work is not started within 180 days of issuance,or if the work is sU3pended for more than 180 days ATTENTION Phpn,: Phone: Oregon law requires you to follow rules adopted by the Oregon L,tility Notification Center Those rules are set Rena I it "Ir'4 forth in OAR 952.001-0010 through 952-001-0080 You may obtain copies of these rules nr direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Exterior Sheathing Insl Rain drain Insp Final Inspection Sewer Inspection Unc.erfloor insulation Plumb Top OI : Low Voltage Water Line Insp Building Final Footing Insp Footing/Foundation Dr; Electrical SF-,vice Gas Line Insp ApprlSdwik Insp Foundation Insp PLM/Underfloor Electrical Rough In Gas Fireplace Mechanical Final Post/Beam ral Mechanical Insp Framing Insp Insulation Insp Plumb Final issued By : 1, „�_� Permittee Signature _" Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000.00310 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/6/00 SITE ADDRESS; 10635 SW LADY MARION DR PARCEL: 2S110DA-07800 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 039 JURISDICTION: TIC TENANT NAME: 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 permit for new single family residence. Owner: FEES RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR y WEST LINN, OR 97062 PRMT GTR 11/6/00 $2,300.00 27200000000 INSP CTR 11/6/00 ;,'5.00 27200000000 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspcction This Applicant agrees to comply with al: 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 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 riot 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 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signature: Call (503) 6.,9-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application hate received: Permit no.:d6-01w—GJ S City of 'Tigard ProjccUappl.no.: Expire date: CityojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 r Phone: (503) 639-4171 Date issued: Receipt no.4coo•7.q Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: 4/ 5 TYPE OF PERMIT . I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family New construction U Demolition U Addition/alteration/replacemetit U Tenant in.provement U Fire sprinkler/alarm U Other:I. JOB SITE INFORMATION Job address: - XlV bldg. no.: 177- Block: no.: — ---- l.ot: Block: Subdivi;ion_ ,�(,(G. N - - Tax map/tax lot/account t Project name: Fisc ' 'on and location of work on premises/special conditions: � +2� !---- -- Q) �p h 1 ' SPECIAL INFORMATION, t t, t Name: �y. �j �, Ff r Mailing address: � �-[ 1 &2 family dwelling. City: State: ZIP: Valuation of work........................................ 64 14 Phune: Fax: E-mail: No.of bedrooms/baths...............................•. —� nwner's representative: - �/ - 6y" Total number of floors•................................ lr �i f'ax: JI., nt,ul New dwelling area(sq.ft.) .......................... —.-�-L_ APPLICANT Garage/carport area(sq.ft.) Name: Covered porch area(sq.ft.) ...................... .. Deck area(sq.ft.) Mailing address: i' ...............................•........ — -- — Other structure area(s ft. City: - State: ZIP: )......................... ------ I nciil Commerelallindustrial/multi-family: Phone: Fax. 1 1 , Valuation of work........................................ $ Existing bldg.area(sq.ft.) ......•...... ............ Business name: New bldg.area(sq.ft.) Address: Number of stories City: StatT 7_IP: Type of construction Phone: Fax: F-mail: Occupancy group(s): Existing: -- CCB no.: N-;w-. City/metra lic.no.: 1 Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in Clic Address: jurisdiction where work is being performed.If the applicant is exempt from licensing,the following reason applies: Cit State: Contact person: Plan no.: --- Phone: t I? -- Lei I Name: t'unta,t lu t m. Fees due upon application ........................... $ 7D -- - - Address: MDate.received: —/� oe --- - City: 5t:ttc: 'LIP: Amount received ...................... ................. $ _— Phone:?,, Fax: :-mail: Please refer to fee schedule. I hereby certify I have 'cad and examined this application and Ute Not all jutiullctions accept credit cards,pleas call judullctton far more Information. attached checklist. Ah provisions of laws and ordinances governing this U visa U MasterCard work will be complied whether specified herein or not. Credit card number: p F� M r:spires Authorized signature: Uate: I V 1► Name of cardholder as shown on cmdit card Print name: EMIKA ,'�— ---'— Cardholder signature $ Amount Notice:This permit application expires it'll permit is not obtained within 180 days alter it his been accepted as complete. 440 4613(W01COM) Mechanical Permit Application Datereceived: ,� t)(J Permit no.:/751 City of Tigard -= -- --- ��ys Address: 13125 SW Hall Blvd,Tigard,OR 97223 Pr°�ecdappl.no.: Ex 'edate: City ujTinard g Phone: (503) 639-4171 Date issued: _ eceipt no.: Fax: (503) 598-1960 Case file no.: , I ayment type; Land use approval: _ I;uildinBpermitno.. 1 &2 family dwel;ing or accessory U Commercial/industrial U Multi-family ew constructio b U Addition/alteration/replacement U Other: U Tenant improvement - -- t SITE IWORMATION1 1 - _-- Job address: AVYR� { - - N, Indicate equipment guamities in boxes below. Indicate the dollar Bldg.no.: Suite no.: _ value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: 5 /� �0719040) - profit. Value$ Lot: Block: Subdivision: 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fc . City/county: ZIP: I Fpt}o(t loc?A'M1w. k°n1p cmise l 1 , 1 IV(+L(i �/ t ---- I Est.date of completion/inspection: Fer(ea.) Total Ihccri(►Ifo�n Qty. Tenant improvement or change of use: C: Res-only Res.only Is existing space heated or conditioned?U Yes U NoAir handling unit --CFM Is existing space insulated?U Yes U No AirCI I IT IIing(sitep anrequire eratxisling ) - Itiono cCsyslem CONTRACTOR Boi er/compressors Business name: Now State boiler permit no.: Address: 'L S 7 - -_- — IIP Tons BTU/H Fir smoke dampers/duct smoked etectors City: �.(fj�pK _State: - LIP: teat pump(site p nn requ re ) - — - Phone �¢ Fax: _ E-mail: rep acelurnac utncr CCB no.. Including ductwork/vent liner O Yes❑No --- - - nsta replac relocate eaters-suspen e- , T— — City/metro lie.no.: — wall,or floor mounted Nanta(please pri lit) Vent for a lance of icr an furnace - - CO 1 eTr gest on: Nan c: Absorption units — Address: �''f -- Cam iressors --- City: State: Zlp; :n� rnnmrnta exhaust an ventilat nn: - Appliance vent Ph ne: Fax: E-mail' - ryerex aust - --- o s, ype / res.Fte a azmat -- Name: kJAI C �,�•� hood fire suppression system Llfi,1 Exhaust fan with single duct(bath fans) Mailing address: u/ •x must system a a t from hcatin or C Pity: 'C_ State: ZIP: �f(0 ue p p ng an i but on(up to out ets) Phone: Fax: - - E-mail: _ _ Tye' LPG NG C)il Fuel iping eac a itionaover out eis _ rocrssp p ng(schcrnaticrrquircd) —" Name: Number of outlets — Address: --- - Z3tth si app ance or equ pmrnt: Decorative fireplace City: State: ZIP: L osert-type Phone - x' E-mail' oo stov pcll�— -- Applicant's signature: L L - Name(print): - �---�___ liter: _ Nn(all jurisdiction accept credit cards,plense call jurixdictlrwi for mem Infonruvlon. Permit fee..................... l I Vise U MasterCard Notice:This permit application Minimum fee................$ t•redli card number:.______ L /_ expires if a permit is not obtained _ Expires within 180 days after it has been Plan review(at _ %) $ Name of car oT r am a ow- , wn on c,rdit card --- accepted as complete. State surcharge(8%).... - s _ TOTAL .......................$ Cardholder signature A'rnoum ---- 44n 4617(60WOM) Plumbing Permit Application J Uate re--ived: /a,;,,00 Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: y• Rt.ceiptno.: Land use approval: Case file no.: Payment type: 1TVPE 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family ❑Tenant improven cw construction U Ac,liti:n/alteration/replacement U Food service U Other: JOB SITE INFORMATION Joh address: ] L&y ,�1��(,� _ .. Description Ipv. �use ec(en.) 'Total Bldg.no.: - _ Suite no.: New I-and 2-family dwellings only: -- -- �L - --- - (include%too It.foreach dtilty connection) Tax map/tax lot/account no.: P6/to—>,q -o7$OG SFR(1)bath Lot: jj0j Ifflock: I Subdivision: ----- ------__ �_ _ __— SFR(2)bath _ Project name: �,�(� — SF1t(3)bath City/county: "i1ld�,p ZIP: Each additional bath/kitchcn Description and location of work on premises:_AUP-W— Site utilities: wry. �ihYtrllL.��} E. Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) PLUMBING CON'.�Jaj�� Manufactured home utilities Business name: / L- Manholes Address: -n2 jo- "f;W �.1 Rain drain connector City: `V� State: ZIP: Al 005-*— Sanitary sewer(no, lin.ft.) Phone I ax Email: Storm se% r(no.lin.ft.) CCB tic,: Plumb.bus.reg.no: - Water service(no.lin.ft.) City/metro tic.no.: - — F'ixtnr�or item: AbEorption valve Contractor's reyqseptative signature__—" �"� m� Back flow preventer Print name: '� I�' Backwater valve hotCONTACT PERSONBasins/lavatory Name: �L .� Clothes washer — -- — A � Dishwasher Address: .� — - Drinking fountain(s) City: State: ZIP. tro .jecrs/sump _ T Phone: 'I ax F mail Expansion tank �WIIWLA Fixture/sewer cap — Name(print): � �,��, (,� floor drains/Iloor sinks huh g ��_A rose bi disposal Mailing address: VTZ, Hose bibh City: UState: ZIP: - Ice maker _ Phon Fax: F.-mail: Interceptor/grease tra (honer installation/residential maintenance only: The actual installation Primer(s) _ will he made by me or a maintenance imd repair made by my regular of drain(commercial) employee on the pm ft own as per ORS Chapter 447. 9ink(s),hasIn(s),Iays(s; Owner's signature:J� Date: �O L Sump 1011 lll�� Tubs/shower/shower pan Urinal Name: Water closet Address: III J7Water heater City: State: ZIP: 011 a.5o Other: - Phone: Fax: E-mail: 'Total Not all jurisdictions atwe credit cards,please call jurisdiction for more infamuVi x Minimum fce................$ } M 1 Notice:This prnnit appy anon ❑Visa Ll MasterCard exp'res if a permit is not obtained Plan review(al — %) $ Cmd11 card number:_. —. — / within 180 days alter it has been State surcharge(896)....$ F:xpirca Name of older u shown on c— edil carte-� accepted as complete. TOTAI. ......I................$ -- $ Cardholder signature Amount 4"16(~OM) Electrical Permit Application "tceived: , ��QPermit no. -a27 Tigard City of 1 igard 11roject/appl.no: Expire date: City njTigard Address: 13125 SW Ball Blvd,Tigard,OR 97"21 Date issued: Oy.—� Receiptno.: Phone: (503) 639-4171 -- Fax: (503) 598-1960 Cine file no.: Payment type: Land use approval: _— TYPE 1 l0 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/aiter tion/replacrnunt U Ocher: U Partial It SITE INFORMATION Job address: L �j .�Q Rldl.no _ Suil no.: Tax map/tax lot/aecount no.: _— l.ot: _ Cilcxk: Subdivision: Project name: Description •nd [(,cation of work on premises: Estimated date of completion/inspection: t7__ 1 1 s 1 Job no: — � Ileriptlonmulli- Qty. (ca) rural no.Imp Business name: ---- New teshlerrtlal-singleormuhi-1rmllyper Address: 0)K 14Z _ dwellingunk.InciudeNattached garage. City: State: IZIP: Servicehtcludet Phone: 'L Fax: E mail: 1090 sq.ft.or less _ 4 G Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus.lie.no: • Limited energy,residential 2 City/metro Ilc.no.: _ Limited energy,non-residential — 2 Each manufactured home or modular dwelling -- --- - Service and/or feeder 2 Signature of supervisin electrician(re wired) [)ate Sup.elect.name(print) Ltrcnseno - -- Servlcesorfeeden-Inslallalion, alteration or relocation: 1 1 200 amps or less - _ 2 BJ i�r7`rNC/� 401 amps to 400 amps 2 Name(pant): 401 amps to 600 amps _ 2 Mailing address: (jj�-W —M iZ 601 amps to 1000 amps _ 2 ity: Cw � �,,�N State: Z1P: _ Ovcr 1000 amps or volts 2_ l'hont: Fax: i',-mail: Reconnect only I Owner installation:The installation is being made on property I own Tempororyservicesorfeeders- which is not intended f sale,lease,rent,or exchange according to Instanailon,alteration,o•relocation: ` ORS 447.d55,479,6 0,7 1. ztxJ amps or less 201 nmps to 400 amps 2 Owner':: signature: -__ Date: L 401 to etxt amps 2 BrancheircuIV-new,alteration, �.y or extension p:r panel: ` , J— 1� Name: PQ - Ip,�^ _ __ A. Fee for branch circuits with purchase of Address: Q 7�- PILI service or feeder fee,each branch circuit 2 City:nc i' mail: _ State: ZIP: r17, B. Fee for branch circuits without purchase 1'ho of service or feeder fee,first branch circuit: 2 �� I'as Each additional branch circuit: Mlle.(Service or feeder not Included): U S'rvuc over 22S 111g1S-CU'11111CtCIal U I lealth-Care f.willty Each pump or irrigation circle U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2` familydwetlings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, *System over 600 volts nominal more residential units inone structure alteration,or extension• — 2=— OBuildingeverthre!stories U Feeders,400 amps or more *Description: ❑Occupant load ov r 99 persons U Manufactured structures or RV park Fich additional Inspection over the allowable In any of the above: U[glcss/lightingplan U Other __ Per inspection Submit ^sets of ptanc with any of the alcove. Investigation fee The above are not applicable to temporary construcCo•n service. Other Na all lutisdictions accept credit cards,please call jMsdieflon f«mme Information. Notice:This permit appliea!ion Permit fee.....................$ -- U Visa U MasterCard expires if a permit is not obtained Plan r.vlc ,(at _ %) $ I've&card number _. within ISO days ager it has been Stale surcharge(8%)....$ Pxpires accepted as complete. TOTAL $ Name of cava t r ss shown on credit card l------Ta—rdhoIde,'ilgnaIure--_S Amount 440-4AIS(60001COM) w a � S 89'53'03" W 60.00' co 911 N.W 61 Wa `J V � 00 C.3c, 2 + '2. N a , 2 l r 3 , W Q iV) ¢4 75.00- S 89'55'34" E BOO S.W. LADY MARION DRIVE --A 2.50' LANOSCA°E FASEMEN' SHA.'- �kS- 6-pN; AL',. STREET FROM AGF.. - -A 7.50' PUB'6.0 wT'L TY EASEYEN? SHALL EX S' A-C,�!G 17HE LANOSCA°S F.ASEVEA CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED IMPORTANT PERMIT NOTICE CRAFTWORK PLUMBING INC COMMUtiIry OFVFlAP1lfal 7736 SV'1 NIMBUS AVE BEAVERTON, OR 97008 Plumbing Signature Form Permit #: MST2000-00458 Date Issu3d: 11/6/00 Parcel: 2S1 ODA-07800 Site .Address: 10635 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 039 Jurisdiction: TIG Zoning: R-3.5 Remalks' Construct new single family detached residence. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC 1672 SW WILLAMETTE FALLS DR 7736 SW NIMBUS AVE WEST LINN, OR 97062 BEAD"ERTON, OR 97008 Phone #: Phone #: 644-8698 Reg #: I Ir 79666 PI M 20-148PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X _ Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RECEIVED GAGE ENTERPRISES INC row PO BOX 1429 COMMUNITY UVROPMENI CLACKAMAS, OR 97015-1429 Electrical Signature Form Permit #: MST2000-00458 Date Issued: 1116100 Parcel: 2S110DA-07800 Site Address: 10635 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 039 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construct new single family detached residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL. CONTRACTOR: RENAISSANCE CUSTOM HOMES GAGE ENTERPRISES INC 1672 SW WILLAMETTE FALLS DR PO BOX 1429 WEST I_INN, OR 97062 CLACKAMAS, OR S'7016-1429 Phc ne #: Phone #: 503-657-0142 Req #: suP 818s LIC 34544 ELE 3.128C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising(ectrician If you have any questions, (,,ease call (503) 639-4171, ext. # 310 I CL w a a o f1 �, JC C o o � 1 ry v11 .o n N z 'J 3 � n O � _ I I