Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2000 -00239
�l� DEVELOPMENT SERVICES DATE ISSUED: 6/30/00
4---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16653 SW 88TH PL PARCEL: 2S114AD 02200
SUBDIVISION: WAVERLY ESTATES ZONING: R -12
BLOCK: LOT: 021 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 8 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: 6 ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: 70 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,560.00
Remarks: Addition to existing deck. 250 sq ft
Owner: Contractor:
PENNINGTON, MALCOLM & SHELLEY OWNER
16653 SW 88TH PL
TIGARD, OR 97224
Phone: Phone:
Reg #:
•
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
PLCK DLH 6/13/00 $38.51 0002895 Framing Insp
Final Inspection PRMT DEB 6/30/00 $59.25 0003387 \ Oi‘ 5PCT DEB 6/30/00, $4.74 0003387
CDCB DEB 6/30/00 $20.00 0003387 O
(additional fees not listed here)
Total $142.50
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 than 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Permitee - �
Signature: ,- - ,46( w . wkL
---jam
Issued y: , 4 ( a aAAA---4-4/
Call 639 -4 75 by 7 p.m. for an inspection the next business day
c Plan Check #6 "" 57Z. CITY OF TIGARD Residential B uilding Permit Application Recd By4
13125 SW HALL BLVD. Additions or Alterations Date Recd Ca / 3 -D
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. ./2Y_____
/
V 503 - 639 -4171 Date to DST `0 :24.441 F 503 - 684 -7297 / � Permit # Q u Paaoo- -De 7.2 3?
Print or Type Called /`�)`.reAI ( /z/ov
Incomplete or illegible applications will not be accepted
Name of Project Name
Job PeAmbiver -foal Architect Mailing Address
Address S ite Address
16653 SW 88th Place City/State Zip Phone
Name
Pennington, Malcolm & Shelley Name
Owner 1 66 55 3ASW Address Place
City /State Zip Phone
Engineer Mailing Address
Tigard, OR. 97224 534 - 2332(503) City /State Zip Phone
General Name _
Contractor Pennington, Malcolm Describe work New 0 Addition( Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit 16653 SW 88th Place Additional r al Description of ,Work: ,Z�� ,�K
issuance, a copy City /State Zip Phone /97717 S 1/
of all licenses Tigard, OR. 97224 534 -2332
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# VALUATION $ 2,560.00
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- /l Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Addre s
Indicate the restricted energy installation by the electrical
Prior to permit subcontractor in the following areas
issuance, a copy City /State Zip Phone Restricted Audio /Stereo
of all licenses
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing Name __ _ _ (check all that Other:
Sub- /i� apply)
M a iling Ad (�ress Corner Lot YES NO Flag Lot YES _ NO
Contractor (check one) (check one)
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City /State Zip Phone
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# I hearty acknowledge that I have read this application, that the
expired in COT
database Plumbing Lic. # 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.
Name Signature of Owner/ Date
Electrical N A 6 -12 -00
Contact Person N a a Phone #
Sub- Mailing ss Pennington, Malcolm 534 -?11?
Contractor
City /State Zip Phone `
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: Map/TL #:
required if Lic.# R .57/ 4//9P , d r i
expired in COT �`
database Electrical Lic. # Exp. Date Ateits : Zone: „ _ / Electrical Supervisor Lic. # Exp. Date En ip eering Approval: Planning Approval: TIF:
- , 3F, 5 / i:\dsts \forms\sfaddalt.doc 11/20/9E
Date Rec'd:
CITY OF TIGARD Rec'd By:
SINGLE FAMILY ATTACHED OR DETACHEDINew, Addition) Plan Check #:
APPLICATION /PLANS SUBMITTAL REQUIREMENTS
Applicants: Please complete
1. APPLICANT NAME: PHONE #:
2. SITE ADDRESS: FAX #
1. 5 SITE PLANS (Fully dimensional, drawn to scale) labeled with:
❑ map & tax lot #, ❑ subdivision name, ❑ subdivision lot #, ❑ site address,
❑ zoning, ❑ applicant name, ❑ phone number.
Size requirement: 8 -1/2" x 11" to a maximum 11" x 17" and NOT attached to building plans.
A. North Arrow.
B. Scale (any standard, architectural or engineering only).
C. Street Names.
D. All building plans shall reflect actual building dimensions.
E. Finished floor elevations (all levels, actual topographical).
F. Garage finished floor elevation (actual topographical).
G. Corner lot elevations (actual topographical).
H. Driveway corner elevations.
I. Zoning setbacks (front, side and rear).
— - J. The location of all public and private easements.
K. The location, termination, and all invert elevations of all drainage piping (sanitary
and storm) showing all elevations necessary to show positive gravity flow to the
approved drainage device (i.e.: peepholes, storm lateral, sanitary lateral).
L. Residential driveways, sidewalks and wheelchair ramps will be shown on site
plans and will be in accordance with the CITY OF TIGARD standards. Drive -way
cuts shall not be permitted within 30 feet of intersecting right -of -way lines nor
within 5 feet of property lines. Weep holes /drain pipes will be installed 5 feet from
adjoining property lines. Multiple driveways on individual parcels of land must
have 30' of separation; joint use driveways require a formal agreement.
M. Show all erosion control devices proposed for site; refer to UNIFIED SEWERAGE
AGENCY (USA) Technical Guidance Handbook (Revised 1994), or telephone
USA at 648 -8621 for assistance.
N. Show location of existing facilities and new or relocated structures (mailboxes,
power poles, water meter, light pole, stop sign, etc...).
O. Indicate property slope directions.
P. Existing and finished contours when slope in any direction exceeds 20 %.
(ADDITIONAL REQUIREMENTS MAY APPLY, SEE GRADING POLICY).
iAdsts\formslsfreq.doc 4/20/99
•
Permit #: f4T2O0 0 — 00 2 ? 3
F . •
Address
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••� Issue' by -du_ /, . i,, Date:
1 8 f s
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
r��.,� 1. I own, reside in, or will reside in the completed structure.
M 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
uLed. before or upon completion.
n 3A. My general contractor is
I (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
�j� 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners abo t Construction Responsibilities on the reverse side of this form.
i/ k _ _ ∎� 6 — 5c g
� tore of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP ODU -D 0073 6
Date Requested 7- ve AM PM BLD A
Location /<, c' C3 5 w 8Z i (L Suite MEC IN,
Contact Person Ph 573 -5 -2)31 PLM � _
Contractor Ph SWR
BUI Tenant/Owner ELC
etaining 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 CCe CC) J'�^ /✓ J 'G Tr /-7.
Fire Alarm
Susp'd Ceiling
Roof n -��
1
Misc: /X
, PART FAIL
=NG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
BackfilUGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk /
Other Date 7/? [1 c t / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP dev -ovq3
Date Requested 7 -- t' AM PM x BLD
Location OS /66'.,c �(� � Suite MEC
Contact Person Ph PLM
Contractor Ph SWR �1
1l LD11 4 1 Tenant/Owner ELC
Retain' Wal4,, k_ ELR
.,.,., ,�} e.G Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ,J�
Slab ` `,( L /GuSA d7'I Y SIT
Post & Beam �` /�
Ext Sheath /Shear V 'j4. w -� "I 7) Lets k /'[k l w�4'j
Int Sheath /Shear
Framing
Insulation /
Drywall Nailing / _ •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 1, �� / a % •�' if /
Roof
Misc:
PART FAIL
• II MBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low 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, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date /)-)
Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.