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10669 SW LADY MARION DRIVE N 89`53'03" E 60.00' Coiv7'rco l • � Z- �E-2 GCS � i— I;z ij� ao to v w M �V�.� e- 3 14 N r 10.00'P n 0 1.67' 10.33' 9LE Saslow I I w I 4 rmF N :— w Vm w 3 0 344 o I � o I w r' I � ( 0 6.67' 32.00' I o 13.•33' ;n . f 3x13 L-�s. 7 R625. 0o c. �►� R 1 . 29LADY _ . MAR � O/V 00 3A2. DR � V E SCALE .LIRA WING LOT 41 ERICKSON HEIGHTS S.E. IZ4 SEC. 10, i.2S., R.1 W., W.M. 1040) S W LADY MAS Of CITY OF TIGARD /060 ' WASHINGTON COUNTY, OREGON .L� --- A .. LANDSrAPE EASEMENT SHALL EXIST MARCH 28, 2001 ALONG ALL STREET FRONTAGE AND A 7.5' UTILITY C e n t e rl i n e Concepts Inc . EASEMENT SHALL EX!S T BEHIND THAT DRAWN BY: MSG CHECKED BY: WGDIII SCALE 1 "=20' ACCOUNT # 115 EMAIL WWW. CCIEMAIL®AOL.COM 640 82nd Drive Gladstone, Oregon 97027 -- M: \MLI\L41 ERICK 503 650-0188 fax 503 650-0189 .. ... . . � Ir � r( � -I�i- i—l� If�i1 T IMAGE 13 NOTAS CLEAR AS THIS NOTICE, L r_ � � - � � n �0111 0i III I f l I I I 1 I I 1 4 $hOTICE: IF THE PRINT OR TYPE ON ANY I I I I I I II IS DUE TO THE QUALITY OF THE No.38 0`� CON— IT ORIGINAL DOCUMENT E ' 6 Z 8 Z L Z 9 Z Z Z E Z Z T Z 03 6 I 8 T L T 91 4 T fi T S T Z T T T T 6 8 L 8 2 i► I II..I�IIIIllilllilLIIIIIIIIIIIIIIIIIIIILIIILII t I �l ll lul�il111.1Illllllllulllllllllllllllllllli�llllllll :IIIIIiillll� Ill, ,llllillllu�llflLl�lllll llllll� ullll_Ilu.� (_Ilrlyl►ll 4 Of CA I r CL o� 0 v f A669 SW Lady Marion Drive CITY OF TIGARD BI IILDING INSPECTION DIVISION MST <<,� � ov 1 Z 24-11-11-us ; -ur , ,specuun Line: t,,,i4176 Business Line: 635 .71 BUP Date Requeoted _ /i" AM —PM SLD Location / �-�. ?2 Suite ti;FC Contact Person - -t_ A Ph Li c( -3 I Z_- ?LMA Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR _ Footing Access: FPS Foundation Ftg Drain SGN Crawl Drain Inspection Notes: Slab _ SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling —._— Roof Misc: ----------— — — Final --------- PASS PART FAIL ------ ---- - PLUMBING Post&Beam —- Under Slab Top Out — Water Service _ Sanitary Sewer �— Rain Drains Final ------�--- -- PASS PART FAIL MECHANICAL — Post& Beam — — Rough In Gas Line — Sm0e Dampers Final --- — - -- PASS PART FAIL ELECTRICAL ----- Service _--_ ------— -- — — -- Rough In UG/Slab —- — — ------ -- Low Voltage cSS RT FAIL Backfill/Grading -- - — - -- ------ — - Sanitmy Sewer Storm Drain [ Reir�pertion fee of$_ required before next inspet.tinn Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ please call for reinspection RE — [ ] Unable to inspect- no access Fire Supply Line ADA / Approach/Sidewalk Other Date Inspec r �_— Ext — Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD B111LDING INSPECTION DIVISION MST �- 24-Hour Inspection Line: 3-4175 Business Line: 63L .171 BUP Date Requested y�y AM PM RLD — Lc ation Suite`` MEC 1 Contact Person '-�-WI Ph T `� �l U Z PLM Contractor _ Ph SWR BUILDING 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 NailingFirewall Fire Sprinkler ZT141 �� r' "'1 "D�.G�S �►"� 07'� . Fire Alarm Susp'd Ceiling --- -- — - Roof Misc: - Final PASS PART FAIL ---- - - - PLUMBING Post& Beam -------- - _ � --- Under Slab _^ Top Out - -----J---- - Water Service Sanitary Sewer — - Rain DrainsASVPART FAIL _-__ -- ----- - --I&SCHANICAL Pc.st& Beam ------- -- — -- -----.--- - tough In Gas Line - - - ----- — Smoke Dampers Final ------- - — - ----—--- PASS PART FAIL_ _ ELECTRICAL ------ — -- Service — Rough In UGISlab _----- — -- -- — Low Voltage Fire Alarm Final _--_-__-- _-- -- - -- ---- Final 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 [ ] PleaF,3 r call for reinspection RE: __- [ ]Unable to inspect- no access ADA �} Approach/Sidewalk Date / 7 - o Insppctnr— �1 0 clV-e- Ext Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. r'ITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - _ BUP _ Date Requested " AM PM BLD Location 1 G I - X ��y '6uite MEC Contact Person L -L�,FC _ Ph �1 �o el 7 � ~� PLM Contractor Ph SWR BUILDING _ Tena.'./Owner _ ELC Retaining Wall ELR Footing Access: Foundation FPS - Ftg Drain SGN _ Crawl Drain Inspection Notes: Slab -- SIT Post U B-am Ext Sheath;Shear Int Sheath/Shear Framing L c v'yt Z,) - InSUlatlon Drywall Nailing -- Firewall Fire Sprinkler - - Fire Alarm Susp'd Ceiling - - - Roof Misc: �- -- ---- -- rcir ASS PART FAIL - ---- ---- - MaNG Post& Beam ^ Under Slab ,_-____ ----- ----- --- Top Out Water Service - Sanitary Sewer — Rain Drains — Final PASS PART FA+L --- MECHANICAL Post& Beam --------------- - - - — Rough In --_--_-_ _—_-- (,as Line - -------- .-. ------------ Smoke Dampers S PART FAIL ELECTRICAL �------- -- — -- -- ------- Service - --...----- -- --- ------ --- Rough In UG/Slab —.__— -- ---- - - Low Voltage Fire Alarm -- -- - - ---- ---- Final PASS PART FAIL --- ---- — -- SITE Backfill/Grading -- — — Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspect.-)n. Pay at City Hall, 13125 5W Hall Blvd Catch Basin Unable to inspect-no access Fire Supply Line [ ]Please call for reinspection RE:-`_.— [ 1 P ADA Approach/Sidewalk Date �'�- �'S� 4) Inspector —__ — Ext Other - Final PASS.-PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00359 "3125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 08/15/2001 PARCEL: 2S110DA-08000 SITE ADDRESS: 10669 SW LADY MARION DR SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 041 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: TI1B/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow :evention dev ca. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 27200100000 1672 SW WILLAMETTE FALLS DR 5PCT CTR 08/15/2001 $2.90 27200100000 WEST LINN, OR 97068 — — Total $39.15 Phone 1: 503-557-8000 Contractor: MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 503-630-5532 Final Inspection Reg#: LIC 5973 PLM 11717 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State cr 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 suspende-' 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 952-0001 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: r_x ,' Permittee Signature: . ,G Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 1 � I . sTaoOi- no�� Plumbing Permit Application Datereceived' o /0/ Permit noj: Z°11_,^X _14 City of Tigard Sewer permit no Address. 13125 S W Hall Blvd,Tigard,OR 97223 1 Building permit no.. CirvoJTlgard Phone: (503) 639-4171 Project/appi ne.: I Expiredatc: Fax. (503) 596-1960 Date issued; By./�/- I Receiptna.: — Land use approval: Vase the no., i'eyment type Ll ' family dwelling or accessory U Commercial/industriat 0 Multi-family 0 Tenant improvement ltilNew construction Cl Addition/al teretion/replacemen t 0 Food service J Other: Job address: Deac tion . Fee ea. iota[ Bldg. -- Mew I-and 2-familyweWnp only: no.: Suite no.: (includes 10011.for eachutlUty cotutectlon) Tax map/tax lot/account no.: - — - r;- SFR(1)bath i LLot: Block: I Subdivision: —c5i Z( bath Project name: _� Se.t. e �/,+Zs SFR(3)hath �---' Cit /county: 'y`� L3i,'r,' It �� Z 2 Lac ad tion blUMtehen Des,�ripuu— n and location of work on premises: Nr;ye/ts SUeutWilles: i Catch bt a:rdura drain �welTc�ch linu►r;nch drain Est.date of compleuoNinspeaion: rY . Daum drain(noKam's I ME Ell" . Manu acturedhome utilities Business name: •, c( ,vl� ,y�, Manhole's I Address 1t 7/3 _ n drain connector city: EVA 11 •11 State:O ZIP: �f 7C Sanitary sewer(no. lin. ft.) Phonc: c ic J Z Fax:f•.,i� F-mail: Storm sewer(na. tin.ft.) CC13 no.: //7 j Plumb.bus,reg, no: ry'y� ater setvicc(no,lin. ft.) C: Fixture lie. nu Fixture or item: ,, Absoron valve Conttactor's representative signature: % �^ Back flow preventer Pant name / v . Date: �� " �� - / �acwatet valve , Bansat Nane: s was er ; 7 DrinUn 1r+hWEa er Address: 174- - �*-- --- --- _ _ ountain(s) City: LS �t�:.�.: c _ 5taterC% ZIP: t"z� -----�1 -- --._ E ectors/sum _ Phone: ,,�? C fc e6-�, Fax: f4.rir E-mail: _x ansion tank —Y Fixture/sewer cap - Name(print): 1 Fluor drains/floor sinks/hub — —' Maddress: Garbage d os� Mailing g --• - !lost bibb City: - _ State: ZIP: _ Ice maker Phone. Fay: E-rnaiL nterce tor/ lease tra -- —' Owner uistallationlresidential maintenance only: The actual installation meKs) will be made by rn6oc-, ntenance and repair made by my re�,iar Roof rain(commercial)employee un rite pI w es per ORS C pter 447. to (s), astn(s), ays s Owner s si natureDate: r' um Tu slshower/shower pan --�� 4ame: Urinal — _• rr Address: stet closer Water �,_`--- heater City _ State:_ L1 --- ---- -- --�-- Phone: — Fax. E-mail: otal Nor dlMinimum fer......... ...... )urivdu:tiunb ecr<pi radii •,plrnee�JI jucladictlon fa mon infaTDil011 Notice:This permit appllcetion Uvies U Muterc rd expires if a permit is 6% h te surcharge( ) $ not ebtamed Plan inview(at — A, $ C:1& _ cud num,er: _ ---- —�-1--- within 18U days after it has been Sta - Nune"Jr c otti;_r w i awn nn cr d t eud p accepted as complete. TOTAL ............. .... . $ _ s _ Cardholder tiitnatum Arnounl atJ�6tt3(WWICOMI q• :r a n con a o H ks o .O O O � w s a o N a �I r AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA � o b ► (� t d � . ► ZTJ f 44 4 CL °� ► 4 a 1 t7- ! 4 `r 4 i� o V CLalp l J N 4� f- i N 44 �' Y �` ► 44 44 pol. 44 ?, ► 44 ' � ► 441 loo� o 4 ► CITY OF T I G A R D MASTER PERMIT PERMIT#: MST2001-00212 DEVELOPMENT SERVICES DATE ISSUED: 4/18/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10669 SW LADY MARION DR PARCEL: 2S110DA-08000 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 041 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,704 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1 752 of GARAGE: 501 of FRONT: 20 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMF.NT: of RIGHT: 5 VALUE: 5 313,]ZH50- OCCUPANCYGRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,46600 of REAR: 47 PLUMBING SINKS. WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: too SF RAIN DRAINS: 1 CATCH BASINS. TUB/SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<t00K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>=100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP. btu FLOOR FURNANCES: VENTS: 1 WOCGDSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION EA ADD'L 500SF: 6 201 400 amp: 201 400 amp: 1st W/O SVCIFDR: nn SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL.BF!CIR: SIGNAL/PANEL IN PLANT: MANU HM/SVC/FDR. 601 1000 amp601�amps•1000V: MINOR LABEL: 1000+amp/Volt: PLAN REVIEW SECTION _ Reconnect only. 1=4 RES UNITS: SVC/FDR-225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO S S'EREO: x VACUUM SYSTEM, X AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDO(R LNDSC LT: BURGLAR ALAOM X 0TH: ALL ENCOM BOILER: HVAC: LANDSCAPE/IRRIG: PROTf CTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION. MEDICAL: OTHR: HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,391.97 This permit is subject to the regulations contained in the RLNAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code, State OR Specialty Codes and 11„'2 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR V,/FSTaccordance LINN. OR 97068 WEST LINN,OR 97068 all other applicable laws. All woo rk will be done it with approved plans. This permit will expire if work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION. Phone. Phone: nregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set ReeN 11( 04"`,55 forth in GAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by Lalling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Fin,I Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insl Water Line Insp Final inspr ction Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Appr,Sdwlk Insp Building Final Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Electrical Final Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Mechanical Final Issued By : �:L,—,. Permitt,)e 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#: SWR2001-00140 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/18/01 PARCEL: 2S 110DA-08000 SITE ADDRESS; 10669 SW LADY MARION DR SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 041 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEI.A,1 DWELLING UNITS: 1 TN PE 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 WEST LINN, OR 97068 PRMT CTR 4/18/01 $2,300.00 27200100000 INSP CTR 4/16/01 $35.00 27200100000 Phone: 503-557-8000 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the ruler, 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 mpasurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the inMaller 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: � � �; '�"" 7� � Permittee Signature: Call (503) 639•4175 by 7:00 P.M. for an inspection needed the next business day 4P7 (7/ Building Permit City of Tigard Expire date: Cit of Rand Ti Address: 13125 SW Hall Blvd,T,, — - `I Date issued: By: Receipt no.: Phcnc: (503) 639-0171 / - - --- Fax: (503) 598-1960 Ie0 Case file no.: Payment type: I 1&2 family:Simple Complex: Lance utir approval: _ _ _ _ �--` - TYPE 1 ' �►1 2 family dwelling or accessory U Commercial/industrial U Multi tanulp KNew construction U Demolition U Add ition/al teration/replacement U renant improvement U 1'11r ,pnin lrtlalann ❑Other: JOB SITE INFORMATION Job address: (� 1r�' 1_ pY ARION Q(L- Bldg.no.: Suite na.: Lot; Black: Subdiviswn: �� ,,t04 HTS Tax map/tax IoUaccount nc . A�//Obq-08610 Project name: Description and location of work on premises/special conditions -------- Name: � � . (Floodplain, solar, Mailing address t &2 family dwelling:IA . City: �,. State: ZIP: �'�t�Y Valuation ofwork......��. .. .7.g............... $ Phone. - Fax: L-mail: No.of bedrawms/baths................................. ;2wner's represent five: Total number of floors................................. Z _ Fax: Email: New dwelling area(sq. ft.) ............... ..Garage/carport area(sq.ft.)......5.0.1......... Covered porch area(sq.ft.) /.8.O........c: __ Mailing address: �_ peck arca(sq.ft,)........................................ - G+her structure area(sq.ft.)............. ........... City: State: ZIP: - -- Phone: I ,t� I'.-mail Cmmmercial/industrialimulti-famlly: 1 1 Valuation of work........................................ $_ Existing bldg.area(sq.ft.) .......................... Business nanie: _ New bldg.area(sq.ft.)............. . _ Address:CityNumber of stories : tate:SZIP: - -� � Type of construction. ............... ................. �— Phone: Fax — E-mail: Occupancy group(s): Exi'>,ting: CCB no.: New: City/metra tic. m t All contractors and subcontractors are required to be with the Oregon Construction Contractors Board under tF s of ORS 701 .md may be required to be licensed in the on where worl:is being performed. 11 the applicant is cess: rom licensing,'he following reason applies: -- - -- Cit : Stutc: LIP: g Contact persnn an no.: -- Pbant•'�• l� lax: Gm.ul• _�■ Narnc: PL u�_ 1��L1 -_ ('+ntact person: m Fees due upon application ........................... $ Addres,:4t+i1 ,5wj�l,—�hlu7 Date received: Cit LV 17-- State: ?IP:/17 Amount received ......................................... y . Phone: Fax. E-mail: Please refer to fee schedule. — hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call Jurisdiction for more inf-Nmation attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard work will be complied� ' +, G,hether specified herein or nol. cRdit cud number �CS Authorized signature: _ Date: a I Nune of cudholder u shown on credit card Print name:__P~. Mum— Cardholder signamte Y s Amount_. Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Baa-ael�(eintivc �+ Plumbing Permit Application Date received: Permit no.: 1` Ity' Of Tigard Sewer permit no.: - Building permit no.: Address: 13125 SW I fill Blvd,Tigard,OR 97223 -- CinujlihurJ Phone: (503) 639-4171 Pmject/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: - -_ By. Receipt no.: - Land use approval: - - Case file no.: Payment type: OF PERMIT , I &2 family dwelling or accessory U:'onunercial/industrial U Multi-family U Tenant improvement ' New construction U A(IrllUon/alteration/replacement U Food service U Other: INFORMATION.1011 SITE 1ULE(for special Information Job address: �V� Sul L,�/ PY MAILIVW PV Desert Kinn cry. hce(ca.) 'Total Bldg.no.: - -sSuite nu.: New I-and 2-fandly dwellings only: Tax map/tax lot/account no.: (includo%too ft.foreachutflityconnection) Lot: Block: ----77Su--bdiv--ision: - SFR(I)bath _ SFR(2)bath — - ---- Project name_�,4 _ _ SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description and location of work on premises:_ Siteulilitles: ,51p olm _ A'1'Y wy ftow f, _ Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain CONTRACTOR Footing drain(no.lin. ft.) Manufactured home utilities Business name: CWT 44jo{C. _ Manholes Address: Q—PWRVY2 - Rain drain connecter City: ___ State: LIF'_ 01 _-- Sanitarysewer(no.lin.ft.) - Phone Fax: E-mail: Stone sewer(no.lin.ft.) _ CCB no.: . ` ` Plumb.bus.reg.no: .f4jb�-W Water service(no. lin. ft.) City/metro lic.no.: Flmure or Item: Contractor's representative signature: Absorption valve -- Print name: Date: - Back now preventer Backwater valve _ CONTACTPERSON Basins/lavatory _ Name: PET-1 VOLZAI-D Clothes washer Address: -Dishwasher - City: Stat Drinking fountain(s) - _ e: LII': ----- - -- �- Ejectors/sump Phone: Fax: F:-mail: Expansion tank - 1 rfxture/sewer cap Nauic(print): j WA j,.976Aj44f, 4t)gW r"MF•g floor drains/floor sinks/hub - - - - Garbage disposal Mailing address: F 'L �lbt! W Hose bibb - ------ -_ k.1,r�Fg1 lhl�- D . City:W LINO _ I State: Ice maker Phon Fax: I E-mail: Interceptor/grease trap Owner installationhesidential r,aintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) emh!oyee on the pro ,1 own as per ORS Chapter 44-/. Sink(s),basin(s),lays(s) Owner's ai nature: _ Date: 4141clil Sump K101" N Tubs/shower/shower pan FAG NW. Wei *11jtA Urinal Name: Water closet -- Address: t �j�fLF,1�. pv hl• Water heater - City: state: zip: 1 1 other: Phone:9P JAR I Fax: • d E-mail: 7 metal ---- Not all jurisdictions accept credit cards,plea call jurisdiction for more informmion Minimum fee................ Notice:This permit application U visa U MasterCard expirt s if a permit is not obtained Plan review(at _ %) $ _ c•tedit card number._-- _T-- J . ' State surcharge 8% . - I pries within I s0 days eller ft has been g ( ) ••••$ -- -- accepted tet complete. TOTAL ......................$ _----- Name or cardholder as shown on credit card p P Cardholder signature Amount 4404616 trutx)/COM) Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: - Expire date: City njTignrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: - -- Phone: (503) 639-4171 Fax: (503) 598-1960 ('trso file no.: Payment typo: Land use approval: — 1 &2 famihr dwelling or accessory U Commercial/industrial U Mniti Glrnily U Tenant improvement New construction U Addi!inn/alteralionheplacement J(Blot — U Partial Job address: Q rh 1ow ISldg.no.: Suite nn.: Tax map/tax lot/account no.: - L2L__41 Brack: a Subdivision: Proiect name: - —- Description and location of work on pren.I,es: 411`1 MA 6F. �'R1►a la y Estimated date of cum letion/ins etion: I mall Max Job no: --- - Descriptloi, lJly. (ea.) 'total no.itis r Business name: L . . L _________ _ Ncw resldenlial single or mull-fandly Icer Address �� I Z41 _;�- dwellinguniLhacludesanoich dgarage. State ZIP:01705 Seniceincludcd! city: LLL _ 1000 sq.ft.or less 4 Phone: `0 �. Fa • Email Each additional 5(10 sq.ll.In puriiun ilei of - CCB no.: 4_ Elec.bus.lie.no: �j Limitedenergy,residential 2 City/metro lic.no.: Limited energy,non-residential 2 Each manufactured home or nodular dwelling Date Service and/or feeder _ 2- Signature of supervising electrician(required) __ Services or feeders-Installation, Sup.elect.name(print). License no: alteration or relocation: 200 amps or less 2___ /'' �,{�� 201 amps to 4W amps _ 2 Name(print)- Itt A � �/OW_I1jMF_oI 401 amps to 600 amps _ 2 Mailing address: 11 9W 1 L4MVW�� 01 amps to 1000 amps � _ 2 Cit L N Slate:M ZIP: Over 1000 amps or volts 2 Phortt. r Fax' E mail: Reconnectonly - - ------ 1 temporary,services or feeders- Owner installation:The installation is being made on property 1 own installation,alteration,or relocaIlon: which is not intended for sale,lease,rent,or exchange according to 2W amps or less ORS 447,455,479, 701. 201 amps to 400 amps Date: DI 401 to6fxlam - Owner's sip-nature: - -- - Hranch circuits-new,alteration, or extension per panel: s Name: A. Fee for branch circuits with purchase of �tl,Wl��l/_ tN ��(�---- — Address: L L service or fearer fee,cacti branch circuit City. 'J�L_v N State: /I1: B. Fee for branch circuits without un;hase of service or feeder fee,first branch circuit: Phone 3• � I�a"�" F-mail: Loch additional branch circuit:&NM ill M1 11111111111ALMUM — - -- Mbc.(Service or feeder not Included): ❑Service over 22Sarnps-o:ommerciol U H_althEach pump or irrigation circle 2 -carefrcility --• - �-� i U Service wer 320 amps-rating of I&2 U Hazardous location Each sign or outline lighting _ family dwellings 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 in one structure alteration,or extension" _ O Building over three stories U Feeders,400 amps or more "Desc-i tion: __-- U Occupant load over 99 persons U Manufactured structures or RV park tach addilional Inspeeilon liver lite allovtolde If,ar1Y of the AIN)to- » U 5grcU Other:sa'lightingplan —_ l'rrins,ccuun Submit_sots of plans with any of the above. Investigation fee _ The above are not applicable to temporary construction service_ Odrcr - Permit lee.....................$ N,I all jurisdictions accept credit card+ pi.-•r.q!!jwisdiction fin more inGamatinn. Notice: Phis permit application U Visa U MasterCard expires if a permit is not obtained Platt review(al _ %) $ credit card number. .___ — __..L—_L__. within 190 days alter it has been State surcharge(8%)....$ [spires accepted as complete, TOTAL. .......................$ Name of car of r u shown on credit cmd S _ Cardholder signature _Amount 440.4615(61t10KOM) Mechanical Permit Application Date receiveo• Permit no.: city of Tigard Project/appl.no,: � Expire date: CJtynjTigard Address: 13125 SW Hall Blvd,"I igard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 5914-1960 Case file no.: Payment type: Land use approval; Building permit no.: I &2 family dwellint,or accessory U Coinmerciallindustrial U Multi-family U Tenant improvement New construction U Add ition/alteration/replacement U Other: Job address: �� Y. N Indicate equipment quantities in boxes below. Indicate the.dollar Bldg. no.:V Suite no.: —_ value of all mechanical materials,equipment,labor,overhead, Tax map/tax Iot/account no.: profit. Value$ Lot: Block: Subdivision: 1_ 'See checklist for important application information and Project name: R�� jurisdiction's Ie,, schedule for residential permit fee. City/county: I zip: a('1 22I NOt ri Description and to •tion of work on premises: `Jl1►lG� � �� £ � ree(esL) total Est.date of completion/inspection: --- Ueuription (2ty Res.unly Rry•only Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?U Yes U No Air conditioning(site plan require ) Is existing spat insulated?U Yes U No Alteration o ex st,ng C systemMECHANICAL CONTRACT61t of er compresso,e �N State boiler permit no.: Business name � HP Tons N i UiN ---- Address:� d t. it smo a ampersductsmoke detectors _ — City: State: . ZIP: eat pump(site p an require ) Phone: j, Far: E-mail:, lnsta repace urnac earner—T10/I Includingductwork/vent liner U Yes U No CCB no.: ZZD ____- nstal replace/reocateheaters-suspended, City/metro lic.no.: wall,or floor mounted Name(please print): --Vent for a 11 lance other t an tt rnace + iON Refr Rcral on: Absorption units_ ___ BTUAI Natne: .�V Ctvent .-s,._ BP Address: — enta ex ust an vent rt on: City: State: ZIP:Phone: Fax: Email: ustpe 1/res. itchen hazmat hood fire suppression system -- -- Name: Exhaust fan with single duct(hath fans) Mailing address: 1, J I(, TAW' Q x aunt sng an a list from eating or outlets) u �� ue p p ng andistribution(up to nut els) City: {.jNN State: . 7.It : �l t 17 — TYPc G NC' Piton I a! Entail: Fuel i ing each_addmona_l over 4 cutlets rProcess p p rfg(sc rematicrequired) Number of outlets _ Name: �G X11 I N�/► __._— they i,.vt app ance or equ pment Address: 'L �_ LV •_ Uecorativefireplac, City: State: _ ZIP: #I'? nsert -ty;re — 4 — — o0 stov@ pC et stove Phon �✓". Email:-Email:: Applicant's signaWrc:U7v Name (print): �'1}}�_ '— a Pe.nnit fee $ _ Not all jurisdictions accept credit cards,please call Juris+fiction for more information Notice:Thisermit application p PP Minimum fee................$ U Visa U MasterCard expires if a permit is not obtained plan review(al _ 96) $ _ Credit card nwnlxt --- -- ;within 180 days after it has been p State surcharge(896)....$ ...— Name of curdtmlder as shown on credit card $ accepted m complete. Cardholder signature Amount 4404617(Mcont 1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERTON, OR 97008 Pluribing Signature Form Permit #: MST2001-00212 Date Issued: 4118101 Parcel: 2S110DA-08000 Site Address- 10669 SW LADY MARION DR Subdivision.: ERICKSON HEIGHTS Block: Lot: 041 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence. Path 1 Your company has been indicated as the plumbing a;ntractor for the permit indicated above. In order for the plumbing permit to be valid, please ha,.e the appropriate individual from your company sign below and return this dumbing Signature Form prior to the start of the work to the address above, ATTN-. Buil&ig 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 97068 BEAVERTr)N. OR 97008 Phone #: 503-557-8000 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, ex;. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTA"IT PERMIT NOTICE RECEt� D GAGE ENTERP,',)ISES INC AQR a Zed i PO BOX 1429 �MMI�MIIY LrFVf1bPM�Nr CLACKAMAS, OR 97015-1429 Electrical Signature Form Permit #: MST2001-00212 Date Issued: 4118101 Parcel: 2S110DA-08000 Site Address: 10669 SW LADY MARION DR Subdivision: ERICKSON HEIGHTS Block: Lot: 041 Jurisdiction: TIG Zoning: R-3.5 Remarks: Construction of new single family detached residence. Path 1 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 supe;rvising electrician is required. Please have the appropriate individual from your company sign helow and return this Electrical Signature Form prior to the start of the 'Nork to the address above, ATTIC. 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`iViLLAMETTE FALLS DR PO BOX 1429 WEST L'INN, OF 97068 CLACKAMAS, OR 97015-1429 Phone #: 503-557-8000 Phone #: 503-657-0142 Req #: SUP 6185 LIC 34544 LLE 3-128C AN INK SIGNATURE IS REQUIRED ON THIS FARM Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310