Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00484
ik D EVELOPMENT SERVICES DATE ISSUED: 10/6/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14925 SW 100TH AVE PARCEL: 2S111CB -02601
SUBDIVISION: MURDOCK HILL ZONING: R -3.5
BLOCK: LOT: 007 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS 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 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: 20 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: -/k// c l'°
Remarks: Construction of 49 square foot attached pool shed.
Owner: Contractor:
WINSTON, MARK OWNER
14925 SW 100TH AVE.
TIGARD, OR 97224
Phone: 503 - 624 -1633
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 10/6/2004 $62.50
[TAX] 8% State Surcharl 10/6/2004 $5.00
[BUPPLN] Pln Rv 10/6/2004 $40.63
Total $108.13
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (5-031746 •. • or 1- 800 - 332 -2344.
•
Iss ed By: i A t LaN i
Perm e /,�
Signature: ���
Cal 639 -4175 by 7 p.m. for an inspection the next business day
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NW CITY OF TIGARD
Approved fv1
/nditionally Approved " 1
F >r only the wwdtkk a described in:
P iciMIT NO v co cf Yy
S 3e Letter to: Follow [
Att: h [ I
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: - (503),1139 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /D •— /3 AM PM BUP
Location /(e0 dV Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors -
Ext Sheath/Shear �11�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
`= PART FAIL
° LUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: l ❑ Unable to inspect - no access
Fire Supply Line ./
ADA
Approach/Sidewalk Date /()-- ._ / Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL