Permit ,,
lit. oil C ITY OF TIGARD MASTER PERMIT
PERMIT #: MST2005 -00181
COMMUNITY DEVELOPMENT DATE ISSUED: 5/24/2005
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DB-09500
SITE ADDRESS: 11175 SW 93RD AVE ZONING: R -4.5
SUBDIVISION: REEL ACRES LOT: 001 JURISDICTION: TIG
Project Description: For final inspections, Plumb,Elect,Mech,Bldg for conversion of storage space above garage to
habitable. Change in owner. ** Conversion began without permit, brought under permit with
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: DWELLING UNITS: THIRD: sf RIGHT:
VALUE:
OCCUPANCY GRP: BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
LACAN, MANUEL OWNER laws. All work will be done in accordance with approved plans. This
11175 SW 93RD. 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:
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 952 - 001 -0080. You may obtain copies of these rules or direct
Phone: 503 - 913 - 6319 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 125.00
. REQUIRED ITEMS AND REPORTS
Issued By : Permittee Signature :
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Case Activity Listing 4/13/2006
�: x� 9:11:30AM
TIDEMARK --Cam, Case #: MST2005 -00181 ',
COMPUTER SYSTEMS, INC
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MST1010 Application received 5/24/2005 None RECD BB 5/24/2005
BLD
MST1020 Permit created 5/24/2005 None DONE BB 5/24/2005 Permit created so finals inspections
BLD can be made. Plumbing, electrical
and building.
MST1030 Check for parcel 5/24/2005 None DONE BB 5/24/2005
tags /C W S BLD
MST1280 Issue permit 5/24/2005 None DONE BB 5/24/2005 Owner has signed Owner's
BLD Responsibility form.
MST1300 Issue ELC signature 5/24/2005 None RECD BB 5/24/2005
form 1 � BB
MST2199 Electrical final 6/10/2005 6/13/2005 6/13/2005 None PASS V AMS 6/13/2005 009049 - 01 — 503 649 - 6991 — VM -
STI N
MST2399 Plumbing final 6/13/2005 6/14/2005 6/13/2005 None W • 1 AMS 6/13/2005 009177 -02 —503- 718 -2426 -- VM -
77 STI N —140144
.
MST1730 Case update (see note) 6/14/2005 None DONE AMS 6/14/2005 This work originally begun without
AMS permit or inspection, brought under
permit with MST2001 -00535 which
expired; under permit again with
MST2005- 00 138, property then sold,
/'./19,1;1/0"--, (�2V new permit MST2005 -00181 issued,
00138 marked Case Finalled; all
inspection reports copied /transferred
to 00181.
MST1530 Permit expired by 1/11/2006 None DONE JMT 1/11/2006 per Hap, DO NOT issue another MST
limitation JMT for this work, seperate permits as
required
f -
Page I of 1 CaseActivity..rpt
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CITY OF TIGARD 1/5/2007
R 13125 SW Hall Blvd. 9:50:46AM
`'' Activit Listin
TIGARD Tigard, OR 97223 503.639.4171 y g
Case #: MST2005 -00181
Primary Name: LACAN, MANUEL
Project Name: LACAN
Site Address: 11175 SW 93RD AVE
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,. v' =`'i ,' sms's. •a * -=- i.� -,s,e .�< Y:? w 4e. R,�S ✓`, ,'2+' �% ° ::,,-:� ✓' a a j lH!'i ! j s a -, e .- ,�4"- . - <�.. ���w., v....�,....,�. .- ..�.�. .�z- ,.
470 Return to "I" status 1/5/2007 DONE AMS Administrative return to "I" status in order to show as "Finalled," see BUP2006- 00257.
740 Case finaled 1/5/2007 DONE AMS Final building inspection passed 1/5/07 under BUP2006 -00257 and final plumbing 6/12/06 under
PLM2006- 00301. MST2005 -00181 marked "Finalled" as administrative action to make it clear
that all work is complete.
730 Case update (see note) 1/2/2007 DONE AMS Garage originally constructed under BUP92 -00206 with non - habitable storage space above.
Subsequently converted without permit to habitable, brought under permit with MST2001 -00535
which expired, then MST2005- 00138, replaced under new owner with MST2005 -00181 which
530 Permit expired by limitation 1/11/2006 DONE JMT per Hap, DO NOT issue another MST for this work, seperate permits as required
730 Case update (see note) 6/14/2005 DONE AMS For fmal inspections, Plumb,Elect,Mech,Bldg for conversion of storage space above garage to
habitable. Change in owner. Garage permit BUP92 -0206. Conversion originally begun without
permit or inspection, brought under permit with MST2001 -00535 which expired; under permit
199 Electrical fmal 6/13/2005 PASS AMS 009049 -01 — 503- 649 -6991 — VM - N
399 Plumbing final 6/13/2005 FAIL AMS 009177 -02 — 503- 718 -2426 - VM - N —140144
010 Application received 5/24/2005 RECD BB
020 Permit created 5/24/2005 DONE BB Permit created so finals inspections can be made. Plumbing, electrical and building.
030 Check for parcel tags /CWS 5/24/2005 DONE BB
280 Issue permit 5/24/2005 DONE BB Owner has signed Owner's Responsibility form.
300 Issue ELC signature form 5/24/2005 RECD BB
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