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Permit • CITY OF TIGARD MASTER PERMIT ,,,a, DEVELOPMENT SERVICES PERMIT #.......: MST98 -282 �IP DATE ISSUED: 07/08/98 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S 135DB- 03801Z1 SITE ADDRESS— :11420 SW 92ND AVE SUBDIVISION °DOGWOOD RIDGE ZONING: R -4.5 BLOCK LOT •011 JURISDICTION: TIG Remarks: Kitchen remodel with bay window and cabinets. BUILDING — REISSUE: STORIES • 0 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED -- - CLASS OF WORK.:ALT HEIGHT • 0 FIRST 0 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSNENT: 0.sf RIGHT : 0 OCCUPANCY 6RP.:R3 BDRM: 0 BATH: 0 TOTAL ---: 0 sf VALUE..$: 11500 REAR : 0 — — PLUMBING ----- SINKS • 1 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS : 0 LAVATORIES....: 0 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 GARBAGE DISP..: 1 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 — - MECHANICAL -- - FUEL TYPES FURN (1Y. 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0 GAS FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS 1 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 0 - -- - ELECTRICAL ----------------- --RESIDENTIAL UNIT— -- SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — -- -- NISCELLANEOUS— - -ADD'L INSPECTIONS - 1m SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 ARP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR • 0 LIMITED ENERGY.: 0 401 - 6O amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 4 SIGNAL /PANEL...: 0 IN PLANT • 0 MANF HM /SVC /FDR: 0 601 - 1m amp.: 0. 601+amps- 1'' 0 MINOR LABEL -10: 0 1000+ amp /volt.: 0 -- ---- -- PLAN REVIEW SECTION - Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) V NOMINAL: CLS AREA /SPC DCC: ELECTRICAL - RESTRICTED ENERGY --- ---- A. SF RESIDENTIAL- B. COMMERCIAL AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: .• BOILER HVAC LANDSCAPE /IRRI6: PROTECTIVE SISNL: GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: • . HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL g SYSTEMS: 0 Owner: - ---- - -- - Contractor: - — TOTAL FEES:$ 269.61 VIAENE, KEVIN & STEPHANIE WOOD YOU BELIEVE This permit is subject to the regulations contained in the 11420 SW 93RD AVENUE 3912 SW 141ST Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD OR 97223 BEAVERTON OR 97005 other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is Phone 0: Phone 0: 641 -2722 not started within 1:', days of issuance, or if the work is Reg 0..: .x'.1066 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 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. REQUIRED INSPECTIONS --- Mechanical Insp Insulation Insp Plumb Top Out Electrical Final Electrical Servi Mechanical Final Electrical Rough Plumb Final Framing Insp B Final / \ M1 Issued By :,/ 41j Permittee Signature: I' + + + + + + ++ + + + + + + + + + ++ +++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day —" CITY OF TIGARD Residential Building Permit Application Rec'd By t '13125 SW HALL BLVD. Alteration - Interior Remodel Only Date Rec'd O 6'7 TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. / V 503 - 639 -4171 Date to D T 7 ,Si F 503- 684 -7297 Permit # Print or Type Called 9 - 9 Incomplete or illegible applications will not be accepted Name of Project • Name • Job /ice �`� 01)0 Mailin Address Address site Address /� Architect Mailing MOO 41/ u;. AUA City/State Zip Phone Name�L ,�j ✓ A ph6 ct A.V1N 04 M.d Name - • Owner Mailing Address 7 C' /S�atZip Phone te / 7 Enginee Mailing Address t3"" 4 —1 grs`'J�O '�i City /State Zip Phone • General N e Contractor &A r) y 0 ij ,U, Describe work New 0 Addition 0 Alteration Repair O Mailing Address to be done: Prior to permit 3 4i; , j \ / f laP L A tional Description of orkJ: - , issuance, a copy ply/State Zip Phone i"' V 44, dePtc) it i7UfidGo 1.Y1t7 ,r of all licenses / , d . e 41666 /7,47Aa / are required if Oregon Const. Cont. Board Exp. Date PROJECT `�' expired in COT Lic.# $ 6:644 VALUATION database /06 g 1 6-00 Mechanical. Name NEW CONSTRION ONLY: Sub Sleph 14,v /Ai li to we Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address Prior to permit • //y21) $jj 92 J A ye, Corner Lot YES NO Flag Lot YES NO issuance, a copy City/ tate Zip Phone (check one) (check one) of all licenses .174o41 cl 721,3 t7?(1 -OL S P Restricted Audio /Stereo Burglar are required if Oreg Const. Cont. Board Exp. Date Ener expired in COT Lic.# 9Y System Alar.- database done Ow'Iex, Installation Garage Door ■AC Plumbing Name Opener Systems Sub -• t /-' , / QrT�Wd��/ L �.�t.,ot17'v,J (check all that Other: apply) Contractor ' Mailing Address Will the electrical subco actor wire f•- all YES NO .7C .4.Lc! ;- 2160tIS restricted energy installatio , s? Prior to permit C. 1St to Zip Phone Has the Subdivision Plat reco • - .. N/A YES NO d issuance, a copy , i 0 4 (.4, 479.3 � ao61 of all licenses are regon Const. Cont. oard Exp Datp required if 'Lic.# Z/ Os -( Solar Compliance expired in COT ?�� -Se (Calculation Attaches database Plumbing Lic. # kicp. Date I hearby acknowl- •e that I have read this - pplication, that the 3 1 1 - 1417 P8 _ U--4k information given is correct, that I am the ow -r or authorized Name agent of the owner, and that plans submitted a - in compliance , with Or-!on State la s. Electrical ' 1 K evinl dQt'!U`� Si • � .. re of y• `• - nt Date •Sub- Mailing A dre �� 1t2 � V ss / AEI _ .1, 'o-_ -306! Contractor /J92 5141 • • ct Person 1G _ s on Na. -. Ph_3 # City/State Zip Phone �! Av G�l�� / AF- - — Prior to permit / r FOR OFFI USE ONLY: issuance, a copy / / � J d1 1223 676-640 Plat #: of all licenses are Oreg n Const. Cont. 07,75 Board Exp. Date - required if Lic.# Setbacks: Zone: Solar: expired in COT R ome OW�ei Jul database Electrical Lic. # Exp. Date ' \,(N rj Engineering Approval: Planning Approval: TIF: eZ C Ar('' I:SFREM.DOC (DST) 5/1/98 CITY OF TIGARD Date Rec'd: 1 , SINGLE FAMILY ALTERATION (INTERIOR/REMODEL) Rec'd By: APPLICATION /PLANS SUBMITTAL REQUIREMENTS Plan Check #: Applicants: Please complete 1. APPLICANT NAME: `j,J,0,,4 Levies /1. i1g PHONE #: 4 4'V/' 2, SITE ADDRESS: //q Q S4_,1 C ...0 10/ 47223FAX # a ciG 7Q 1. L ---- 3 ICINITY MAPS (fully dimensional, drawn to scale) labeled with: orth arrow, ❑Street names, ❑ Subdivision name; ❑ Subdivision lot #, ❑ Site address, pplicant name, ❑ Phone number. e requirements: 8 1/2" x 11" to be a maximum of 11" x 17" and NOT attached to building plans. 2. THREE(3) FULL SETS OF BUILDING PLANS (No red line revision or tape -ons). Size requirements: 4' x 36 ", folded into eighths (9" x 127) with the plans inside. (No rolled, reversed or mirrored plans will be accepted). ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS A. FLOOR PLAN(S). B. FLOOR FRAMING (when creating new habitable space). C. ROOF FRAMING PLAN (when creating new habitable space in the attic). D. CROSS SECTIONS. Every set of plans shall contain two cross sections at mid point of each direction. E. BEAM ENGINEERING CALCULATION (submit two copies of engineering calculations for beam exceeding 10 feet in length or any beam that supports a point load). F. IDENTIFY THE ENERGY CODE PATH. (CABO, Appendix E, Table 401.1a) G. WALL BRACING (indicate the braced and alternate braced panels of the foundation and floor plans. Bracing shall meet design standards of CABO, Section 602.9 the alternate method 97 -1, or an alternate engineered). ANY CORRECTIONS MADE IN RED INK WILL ONLY CAUSE DELAYS. I:SFREM.DOC (DST) 5/1/98 Permit #: PSr g` s —d c f F 11 i> ' � ' _ S Address: j /q.R6 5w A la �v - •, Issued by: Date: —g - � \� 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: , V 1. I own, reside in, or will reside in the completed structure. 7 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale 5 before or upon completion. n 3A. My general contractor is (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 5 �✓ 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 about Construction Responsibilities on the reverse side of this form. _ kOmAi, 0;apfro-- 7- F 10 ( ignature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Dlqm *n ft© Pumperrly Owner Li About c ResponariblErdes Note: This Information Notice to Property Owners about Construction was develope(!bythe Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own cout'actor to ccnstruct a eew home or make a substantial improvement to an existing structure, you an prevent many probiirs by being aware of the ollowing responsibilities and areas of concern. REPLOYER NEOPO;MSOILMES: If you hire persons not zn iuir,od with the Construction Contractors Board to do labor in constructing or assisting in the construction or i of a re structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the enup}oyer, you must comply with the following: 0regon's rv!t.lh@hoU6lelng tax lave, As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be }iub}ofu the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945-8091. Unemployment IIIIMUMECe As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For mon:is;nrnzobon,cud/theOnognpEmoloymentDiviuionotdhcI]epurtonento[}funnunRexoucceu at 378-3524. Worilezen^ compensation 8aournrce: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' eoupensatic iisurnnce for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties aad !rio liable i . 6r u>|doimm costs if one o[ your employees ix injured mntbo'ub. For more information, call the Workers' Cornpensic Division at the Oepartment of Consumer and Business Services at 945-7888. U.S.Ilreterma nevmrceScre;'z�: As an emi'ycr, you nust withhold federal income tax from employees' wages. You will be liable for the payment even if you didn't actually withhold the tax. For more information, call the internal Revenue Service at 1-800-829-1040. MTHER RESPONSBOUTIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this p ject.youuren:aponmib\eforremob/iogunyfbUore to meet code requirements that may be brought to your attention through inspections. D^iabilkyamd property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Tirane tO ipervioewmmploymom: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials at the appro iate times so they can perform the required inspections. if you have additional questions, write or call the Construction Contractors Board (PO Box l4l40 Salem, {lDg?30g-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1 /94 (Pevui- w ► ) i'� -i72. CITY OF TIGARD Electrical Permit App ication Plan Che. # 13125 SW HALL BLVD. `-:0O ` tW � , 1 a_�C . Rec'd By � . �', C� ` ,Q. � t Date Rec'd TIGARD OR 97223 - ��,43 Date to P.E. Phone (503) 639 -4171, x30 � � b-- moa) ,� 7 A./,tt e, t-r Pr or T � eCe,oJ'�1•�l ( ZC r Date to D Inspection (503) 639 -4175 /�1 Per • Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Dr :C iC.� ^� Fl c E. Number of Inspections per permit allowed Name (or name of business) 4f- ,vl,.! 4 37FP44..I I£ V e.4- i:Jhc. Service included: Items Cost Sum I Address )t'/Z.0 St.J qz''' Av'C 4a. Residential - per unit City /State /Zip TIC, / ©2 / 9'7223 Each additional it or less $110.00 4 Each additional 500 sq. ft. or Commercial ❑ Residential ® portion thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor Installation, alteration, or relocation 200 amps or less $60.00 2 Address 201 amps to 400 amps $80.00 2 City State Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps - $180.00 2 Job No. Over 1000 amps or volts - $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Exp.Date OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 201 amps to 400 amps Signature of Supr. Elec'n 401 amps to 600 amps $100 2 - Over 600 amps to 1000 volts, License No. Exp.Date see "b" above. Phone No. 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with . purchase of service or Print Owner's Name Xe.vi.N F. Si- p,1a..,1&. VI A4t~r1t- feeder fee. Address 1 i if z o .--;‘,„1 92. n1 D A t/c_ Each branch circ $5.00 2 - city i , �. .� State C2 Zip g 'I�Z3 b) The fee for branch circuits ty CI P without purchase of Phone No. fp/ 0 - 0(0 6 service or feeder fee. First branch circuit I $35.00 - N5 . nU 2 The installation is being made on property I own which is not Each additional branch circuit 16 $5.00 .t�c 2 intended for sale, lease or ren _ f 4e. Miscellaneous � � Q Pii'L . �/ [GCS (Service or feeder not included) Owner's Signature i ' J Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review ection (if required) :* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. 5. Fees: Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ NOTICE Subtotal $ 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # // L ,- „e 4,70 r /� Total balance Due 070 I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION ST 24-Hour Inspection Inspection Line: 639 -4175 Business Line: 639 -4171 g'7 ( �( p BUP II 7 Date Requested p c 9J. AM PM BLD Location 1 SW J q D--t1 rl v e, Suite / _ MEC Contact Person lO./i_ t/ /�-e � Ph '79 -�(PC7 PLM Contractor Ph 6k SWR Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation 3 Pee-Mir- FPS Ftg Drain Crawl Drain Inspection Notes: p J V1 P rrs 86 SGT Slab SIT Post & Beam y � +, / i i\ g� l / - 81. Ext Sheath /Shear K -��1�W 1J �l T" Ina •.-. h /Shear 5/4-1146 APD S ‘ i0 6 �� Framin Insulation j �/ // �j� , / / / Drywall Nailing ta/ Pile- ✓v /�7r ! 7� �T7 T Ak tE , & C -< 03 y Fire wall ' S ��`� /eO tOR Fire Sprinkler GG / A -PP� Fire Alarm Susp'd Ceiling Roof icr• / t i ' - • T FAIL PLUMBIN:� n " ; •` Post & Beam U.. lab 4 Top Out Water Service Sanitary Sewer / Rain Drains FAIL rzr ANICAL' Po =eam 4 ou•h Ins Gas Line Smoke Dampers 4.--(;; PART FAIL i‘ o1 H 14 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 Please call for reinsp-ction RE: Fire Supply Line [ ] p [ ] Unable to inspect no access ADA Approach /Sidewalk D . • Inspector 1(/� Ext Other p Final PASS PART FAIL D • N • REMOVE this inspection record from the job site. • CITY OF TIGARD BUILDING INSPECTION DIVISION qe_(c)-- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 p► BUP l.3 � ,, // Date Requested °Z-7 q d AM PM BLD Location I I `t-�O U W Suite MEC Contact Person S ?PI/ /E 1///4 Ph 670 0 6 6 PLM Contractor WOOD YOU BELIEVE) Ph ( oi K_6 SWR degglaZIW Tenant/Owner r, LP 2 2_ ELC Retaining Wall ELR Footing Access: Foundation %2 �� « L �� ` �� /`/ FPS Ftg Drain 1 / SGN Crawl Drain Inspection otes: Slab SIT Post & Beam Juts ol�� Ext Sheath /Shear J �(�t_. 7 Int Sheath /Shear Framing Insulation rrn / / Drywall A JO NO &t C, /�/ C�L �/lc.c , / � • 9 (� /s� Drywall Nailing /v' NJ Fire wall JV wall P * P po Z , 0 BERT K /44 - S Fire Sprinkler Fire Alarm PTA �1,,C Susp'd Ceiling Her) !-� Roof Misc: /. _! .� -�L�a� ��✓ `/ 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 Smoke Dampers Final PASS PART FAIL Service ,•' ou. h I I UG /Slab Low Voltage Fire Alarm S ART FAIL 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.