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Permit
n CITY OF TIGARD MASTER PERMIT I l i r .:• - COMMUNITY DEVELOPMENT Permit #: MST2009 -00203 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010 Parcel: 1 S 125DA07100 Jurisdiction: Tigard Site address: 9465 SW 70TH AVE Subdivision: KINGS VIEW Lot: 57 Project: Woolard Project Description: Added 290 sf garage addition with 58 sf covered porch. 10/26/2010: Reprinted to include erosion control inspection requirement. DLH BUILDING Floor Areas Required Setbacks Required Stones: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 290 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: No Total: sf Value: $12,635.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain 0 Other Fixtures: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) WOOLARD, JACK DOUGLAS JR OWNER 1 Prcl Pln Site Plan review for Sensitve Land 9465 SW 70TH AVENUE 2 Prcl Pln Wetland/WACO identified TIGARD, OR 97223 3 BUP Ersn Cntrl 681 - 4444 PHONE: PHONE: FAX: Total Fees: $659.25 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. / Issued By:" 0t '� Permittee Signature: r/� PG. � / C T70N n CITY OF TIGARD MASTER PERMIT 1 1 1111 1 > COMMUNITY DEVELOPMENT Permit #: MST2009 -00203 T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010 Parcel: 1S125DA07100 Jurisdiction: Tigard Site address: 9465 SW 70TH AVE Subdivision: KINGS VIEW Lot: 57 Project: Woolard Project Description: Added 290 sf garage addition with 58 sf covered porch. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 290 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: NO Total: sf Value: $12,635.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 • MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea addl Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) WOOLARD, JACK DOUGLAS JR OWNER 1 Prd Pln Site Plan review for Sensitve Land 9465 SW 70TH AVENUE 2 Prd Pln Wetland/WACO identified TIGARD, OR 97223 PHONE: PHONE: FAX: Total Fees: $659.25 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through • • R 952- 001 -0100. You may obtai r - . • : • _ • : • -ct questions to OUNCby calling 503.246.6699 or 1.800.332.2344. ,� o, '_ '' Q • Issued B �� _ �i G� �1� Permittee Si nature -�- On vim" 'v' idow /, Building Permit Application Residential i. rE .. t F Foit OFICi.: HSl ONI.1- RE City of Tigard Dateivea �� Permit No.: 1 1 v(:)�Z �� 1„, , 13125 SW HaI Blvd., Tigard, OR 97223 OCT 1 2009 ply Review g Y , ' ' ,. Phone: 503.639.4171 Fax: 503.598.1960 Date/By: hp o /6 Other Permit: .1.1-6/k is D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / / luri ® See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISIO Notified/Method:'°L / 3 � Supplemental Information L ((( 7���� ? 77� jjjjjj / / ����� N ((((( T6tf.(.( C() ` thq 1-4-,u Cn /( 6 TYPE OF WORK REQUIRED DAT AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all V Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 0 1- and 2- family dwelling ❑ Commercial /industrial Valuation: I / (,35. $� ❑ Accessory building ❑ Multi - family Number of bedrooms: ��``�� ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 0 1446 - 1L{-( t SO fl Q k e New dwelling area: square feet City /State /ZIP: p, arc) Q. Gtr.) -)- Garage /carport area: 'd, 9 0 square feet Suite/bldg. /apt. no.: ) Project name: Covered porch area: ....d 475_ square feet Cross street/directions to job site: Deck area: square feet I 1 CTV P Other structure area: square feet 1I REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF .WORK work indicated on this application. [„ ut t7 d n J � .ry Valuation: $ R T7 ` i 1 / 1 iy r � v Existing building area: square feet E-170 D�-7 . .. ,.� New building area: square feet t°t PROPERTY OWNER ❑ TENANT Number of stories: - Name: V (A7 Type of construction: Address: �. L ( T S (,t) b ,111 ` , Occupancy groups: City /State /ZIP: t q . 4 0 (J�- • �3 Existing: Phone: (9.) ) „ST L — 0 4 0 Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: Oblmr-e BUILDING PERMIT FEES* Address: (Please refer to fee schedule) City /State /ZIP: Structural plan review fee (or deposit): 1'"16,(..E3 Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: l � Amount received: Authorized signature: �.�J 06-Q0 / � O This permit application expires if a permit is not obtained e � within 180 days after it has been accepted as complete. Print name: n c� \,10 c.x Date: \ 0 ( `\,,, f Q * Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(1 l /02/COM/WEB) *- Jakblu 0-crrn ( a NAr Chance c ( rP I , Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFlcl.: Hsi.: ONi:v,_. City of Tigard Received Permit No.: . 51 a 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 0 Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical IGARI) Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITE '1S ARE REQUIRE FOR PLAN REVIEW Yes N ` 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore. on and shall be shown to be a r r licable to the r ro'ect under review. JURISDICTIONAL. SPI 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ 0. ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440-4613T(II /02/COM/WEB) A Electrical Permit A lication . l OR tlrrlcI IISIl ONI.l • ���� City Of Tigard Received r Date/B : Permit No.. 4 • ,,1� Z0 ° 13125 SW Hall Blvd., Tigard, OR 9 2 Plan Review '� Phone: 503.639.4171 Fax: 503.598.196 C T 3 0 2009 DateB : Other Permit: I' 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: ruris: ® See Page 2 for • Internet: www.tigard - or.gov Notified/Method: Supplemental lnformation TYPE OF s ' I'�0F T n( � tl I` // Llt Iv� PLAN REVIEW � I I ❑ New construction JAddition/alteratlo replacement P lease check all that apply y (submit 2 sets of plans items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: Ok, , 100HP or more. occupancy. '� - G I i ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: ( ` G i .` - C � (-41--);):3 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. . FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 • 1 New residential single - or multi- family dwelling unit. (�� � �� l/ LJ( Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 67.84 2 DESCRIPTION OF WORK - (with above sq. R.) � � 1 Limited energy, multi - family I V �k (J_ 0_, ,,?� G , c k ( C am " residential (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and/or relocation 200 amps or Tess 100.70 2 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: ^ c , co u,`,o . 401 amps to 600 amps 200.34 2 \ 601 amps to 1,000 amps 301.04 2 Address: 6-) � (v U ,_ Over 1,000 amps or volts - 552.26 2 �� Temporary services or feeders installation, alteration, and/or City/State/ZIP: \ t�,j`c � relocation Phone: (C) ) s o---(4.-c) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, r , o exc e, co / in o CARS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 _ 2 Branch circuits — new, alteration, or extension, per panel Owner signature: �� / + / Date: I V 1 X31 U� A. Fee for branch circuits with ❑ PLICANT I U CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2 Business nail B. Fee for branch circuits Contact name: without service or feeder fee, first branch circuit 56.18 J 2 Address: Each add'l branch circuit 7.42 , 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or limited - energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 66.25 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 5'6 / 4 Print name: Date: Plan review (25% of permit fee): f State surcharge (12% of permit fee): 6.7 q Authorized signature: TOTAL PERMIT FEE:, C 2_ This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspection)llowed per permit. I:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 46t5T(11/05 /COM/WEB This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. I II BUILDING DIVISION C .. T I G A R D TRANSMITTAL LETTER a TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED SEP 0 9 2010 FROM: adx-/ 1 O Oro (c1-, t` c0 CITY OF TIGARD BUILDING DIVISION COMPANY: PHONE: S1) •3 SDLE D D 6', I ( By RE: CA `eoS cc u0 - 1 O Fy ` /1157-16-61 -00 3 (Site. Address) (Permit/Case Number) �1 t0, 0,, O — a t X 1'2 . 2 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: 1 Description: 1 Copies: 1 Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. 3 Other (explain): 1 i /Uri (j c 1( p i,,∎5 REMARKS: J FOR FFICE USE ONLY Routed to Permit Techn�i Date: /0 /-(/(') Initials. Fees Due: D Yes L]d'NO Fe e Description: Amount ue: $ $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done Applicant Notified: Date: Initials: I:\Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07 This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 71 BUI LDING DIVISION C TIGARD TRANSMITTAL LETTER a TO: < ,VL SO /V DATE RECEIVED: DEPT: BUILDING DIVISION RECE JAN 15 2010 FROM: -b o G 1000Z-19-AL CITY OF TIGARD BUILDING DIVISION COMPANY: PHONE: 5 .5s '/ Q o7 y0 By: '<< RE: /1Sia — Ooh o.3 (Site Address) (Permit/Case Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: 1 Copies: - Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. l. Other (explain): r A/ .2s ,1 - ; 7 A / 4-,/S REMARKS: FOR OF IC USE ONLY - Routed to Permit Technician: Date: (C / (/ Initials: ' Fees Due: 111 � Yes L Fee Description: Amount Due: $ $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\ Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07 CITY OF TIGARD (� BUILDING DIVISION PERMIT #: 1 v� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 �N� l / � � ��( Inspection Requests (24 Hrs.): (503) 639 -4175 ....I.. L ZU5 INSPECTION WORKSHEET FOR DATE: l (o /A/9 TIME: 1 Z , - cj PAGE: SITE ADDRESS: 4'4 ( , 4.14 2`/6 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instr ctions: 0 o C C - q Ci`r L" if . t I VZA ) Ls ` - ( -?- A - ?__C A v im . 1 • CS 'vim CL.e—v -e_ok \_AA C p_e_____....kb-i• A-6 v ..k..,, ,/ ,SA C/vti"- C` -- r-/,, ( S 0 U Nt 1A.-6- -7` 1 q/ (c.(3) CO5-11 ©-,,,, �, 5 ( (k,...,17(_z ) n PASS ❑ PARTIAL APPROVAL ❑ CANCEL VNO ACCESS n FAIL ❑ CALL FOR INSPECTION XADDITIONAL FEES ASSESSED Inspector: VC; " j . % \ Date: [ 6 ) \ /d 1 Phone #: (503) 718 - ( 2--` 1 CITY OF TIGARD 1 `1'020e79— 69 0.o 5 BUILDING DIVISION PERMIT #: rf 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 !! Ad NNu I ll Inspection Requests (24 Hrs.): (503) 639 -4175 `:_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 11/6,\S--- S k 17 ® ft CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: rK1 o 1ZV____ OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: / T7 . - KE - 1 / 41 ' K S o i— 7 A-fr1 r z c) p t Foy.. .L_E A 11-- 4. ■ - - PASS % P' TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL • ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ _ Date: 1 7 30 C9 Phone #: (503) 718 - -■., - ■ I -------- - - -___, .... -- _ _ -- • - RAE- E OF A _ v( 1 t Is'-os - -.. 1 --.1 i A RECEIVED / . I , - I F OC o , __ T 2 3 2009 z . _ - -- -- - , . .. . \I . :l i ■i' , CITY OF TIGARD - BUILDING DIVISION , 1 _._ . egRxtAsift.. _ _t, ._ ----- riz0A-0 Ai 4 n'** ... - : • - 7 --' • • O i - c) 2.- a , _ - NI E.60 u i .. . 4 irk T)LIT--( 1 .. f , . i — alriEssmo. _ - 1 ■ i ,.. tie91/4/ , c pc.EN Er7 "Ill , , s e-icilrev , Lir 1....& 1.1 4 c'ep- r i f I . i IlOY a Mii i i me ! v smp-- . . , — . . .. ..- ---- -- ---- ,....:)- - 1 , •i' . . ' , , - • _ ... . \ I , , . . I . . . , - 1-H ., 1 6 2. 1 4 1 EMI MIMI 1 IIMIE Pc?. 4 ' ri . . • . _ - - .-• . I .... . • , .c‘,71-.1c. oz • 1 \._. , 4 . • 1 / .. ._ .. . „ . • I 1 1 14 ay./ ac9i4e, 1*-1.4.. i V4 , . Etle's.. Pi . , ,.„) . \ i .... I 0 ■ i al 1 - '• f I S .. ._ . o 3 . oil * , -- - - - F I V EIWA- k r ° t I 4 f . 4 . t i ..1 . I , , •, ....40., _ • , / L I 7 .. ...... 1 ...... i v.4.. .... mili __ .-■.., .,, - .... .,,, . --. , .. - -,, •-_,-.- ... ....'''' ,,,. ag. ......._ '*vt- /145 T2 20-0 7 — 00203 ,pc..ivro,' i.xi,4 asP PLN 9 514/ "A7 Ave_ - E ; 170 le ., I 1— 4:7" 1 _ ____ .... _. _ CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: PI4cTZ(Spq. S 7 PLANNING DIVISION: Required Setbacks: ❑ Approved ❑ Now \nrro' rd Side: s Street Side. Front. `u Garage ? Re:W: „ _,. Visual Clearance: ❑ Approtitct C; No! Xnlsrc". Maximum Building Height. feel /Vr 'e - c , \ CWS Service Provider Letter Required ,rg, � A+oib■CC- T • • B) � -es- �c - �r�a� Date: ' ° %z-8 /,.) S. ENGINE RING DEPARTMENT: Actual Slope: % ❑ Approved ❑ Not Approved Site Plan: ❑ Approved ❑ Not Approved By: Date: Notes: kc +;r■ - c Ie_e_3 ( f-s v —S-, CITY OF TIGARD - SITE PLAN REVIEW : UILDING PERMIT NO: M • �•� �. Street Trees: [, Approved ❑ Not Approved Protected Trees: B : A pproved ❑Not Approved N!wes: M -/y Date: 0 t. y4 {�.,( kf - T,. __. / k 1 ( , /y7:l 4,j) 1 aS l efA