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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP1999 -00444 '. DEVELOPMENT SERVICES DATE ISSUED: 10/18/1999 N {- I I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13695 SW 118TH CT PARCEL: 2S103CD -07900 SUBDIVISION: CREEKSIDE PARK ZONING: R -4.5 BLOCK: LOT: 009 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: UNK : sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: 80 ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 3,000.00 Remarks: Construction of a bracketed antenna support for a ham radio tower. No certificate of occupancy required, no change in occupant load. Owner: Contractor: BRUTCHER, JACK L + MARTI E OWNER 13695 SW 118TH CT OWNER RESPONS FORM SIGNED TIGARD, OR 97223 Phone: Phone: Reg #: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Misc. Inspection 5PCT DEB 10/04/199E $4.74 99- 318805 Final Inspection PRMT DEB 10/04/199E $59.25 99- 318805 PLCK DEB 10/04/199E $38.51 99- 318805 ORIGINAL Total $102.50 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. Pemtitee Signature: Issued By: Q ' '- Call 639 -4175 by 7 p.m. for an inspection the next business day C.�TY OF TIGARD Residential Building Permit Application Plan Che ; # 9 1 3125 - .8W HALL BLVD. Additions or Alterations Recd By Date Rec'd 0 TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. /c - //- 99 V 503 - 639 -4171 Date to DST / _( —` .iQ F 503 -684 -7297 Permit # %. — CYO Print or Type Called /J Incomplete or illegible applications will not be accepted Name of Project Name Job a kkriC E V- Architect Mailing Address Address Site Address P I 3 I S U.) i C D u ki 9 7213 City /State Zip Phone Name , / AtI e J IL 1311t.lie(•fe �✓ N me Owner Mailing Address HgnJ t(, 1,04 N J3C -QG 13‘ 4.5 -St.J 'l el Coue -r Mailing Address City /State Zip Phone En -- n 6440 v1L q`7. 3 4: 1- 4IS1,( X5'75- St) 7710111icG1f ° P 1 - City /State Zip phone General Name (1.- 3EAVERTo Oa- 970c8 'AL -X7'9 3 Co V ti) kj L- Describe work New 0 Addition* Alteration 0 Repair 0 Mailing Address to be done: 2- • 72€ Prior to permit Additional Description of Work: / rc (L issuance, a copy City /State Zip Phone B ge l� ANTENAIA S A PPo R 7C �{N '!ZAlk Maio use, of all licenses are required if Oregon Const. Cont. Board Exp. Date PROJECT o expired in COT Lic.# VALUATION $ 3 CX b, database Mechanical Name NEW CONSTRUCTION ONLY: Sub- Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address - Prior to permit Indicate the restricted energy installation by the electrical issuance, a copy City /State ip Phone subcontractor in the following areas of all licenses Restricted Audio /Stereo are required if Oregon •nst. Cont. Board Exp. Date Energy System Alarms expired in COT Lic • Installations Vacuum Irrigation database System System Plumbing Name (check all that Other: Sub- apply) Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO (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. s •ard Exp. Date required if Lic.# I hearby acknowledge that I have read this application, that the expired in COT database Plumb' • • 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 regon State laws. Name natu of Owner /Ag Date Electrical ((( S a,•. /U - 5-5, Sub- Mailing Address Contact Person Name Phone # Contractor . � TA lc 13f1 e rc 14c�— 68' :5 City/State Zip Phone z g� 1 ) . Pi ..�1a -w �F CC�iL,O, Prior to permit �`� ` v issuance, a copy FOR OFFICE USE '' ONLY: >$•798.03d of all licenses are Oregon Const. Co . Board Exp. Date � e4ti k /, s f required if Lic.# Plat #: Map/TL #: °? — � expired in COT 50-• i v ' - database Electrical lc. # Exp. Date Setbacks: Zone: n _ e. ,/ , � Solar: /` / Ele• ical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF: ( L () S . is \dsts \forms\sfaddalt.doc 11/20/98 1`� Permit #: 76u1 Address: ` Issued by: ; I lA Date: /0 —( - 1 4 9 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. ,Filill the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: I f 1. I own, reside in, or will reside in the completed structure. F 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ri 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 cy Ff 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. a4- bt‘dA (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 r- Business Line: 639 -4171 MST BUP lggq - dlo 4- Date Requested X13° j 'Ld0 AM — PM BLD Location 1 041‹ w i/ S CL Suite MEC Contact Person 9 `cam Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing bN /le- 04 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: � ; IV 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 ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ I Please call for reinspection RE: [ I Unable to inspect - no access ADA Approach /Sidewalk Other Date � J�7 hin Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST BUP qq'9 -� y y +! 14 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 I 3-5;.4 � Date Requested j 2 AM / BLD Location '( 2 I I b &F• Suite MEC Contact Person Ph 44001 - S 7 S PLM i I Contractor Ph SWR MEN : UILDIN ct Tenant/Owner ELC . Retaining Wall ELR f/ Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath /Shear Framing U Insulation I cl--sa_cc— Drywall Nailing . ►n C - _ . Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: 41E1 PART FAIL ' BING 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 Date 0 6 Inspector Y� Ext `9 Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .3/ /6NS4(HS %4 HS 4 ENS ..06 ENS JCABLE CLAMPS REQD PERTURNBACK 3/8 HS y(HS �//6 NS 7//6 ENS / /ZHS4 ENS I CABLE CLAMPS READ. PER TURNBACK 9/16 ENS 5/8 ENS SCAN( CLAMPS REQD Ar,QTURNBACK S',FETY WIRE. 9/4 6, 4073 E E TguC10.E S U' AT E CO N F�T1 °N. SAFET`1 W%0.E r��Y - E4 S TuRNf�uGKLE t 1 � '[WIN EavwLaZER CABLE CLAMPS - SPACE CAKE SINGLE• EA�1K•►' A. R'S CLAMPS Co TIMES CASL.E DIA. Iol A CC U -BOLT SHALL SEAR. b � .�jN : Q'` SINGLE Roo ON DEPID ENQ) ,b D , 1 "� ' �-WI"- Roo I /4 ENS 1rJ�RE OP T O (TVRNOuCKLES ,,'/- ' • I 5 /IV" EHS 1.31 RE 1- To aBuCICLES1 - /leap LARGER ..r, .4PPY . ■ / °NOTE.'J'EEDWG, NO. C 6// 2//R3 Fag CABLE 7E /N ' 41 TURNBUC .. - /NT NIJNC D 7:47/I4 h E BLo�K $ -IS g 30 `�. P4 ADD ED 3 /0"4 - MY ,,` . L ADDED NOTE 7 -6:�6 r „ q . -:� E }? T�JRtJeV GLLE R3 7 -ZS r . � .' ,`\\ � . . ,Z ADDED NOTE • `��, ; - � �. /z /erg u c B ►G GRIP \``� /F AWED CAME aAMPSREPDPEX CUYJYZE - • PREFoRtA D <a DATE 1.3Y NO. DESCRIPTION (OPTIONAL - _N TI{oO CC 4, A'YTACHMEt \' SINGLE EQUALIZE& ft'- REVISIONS '' UNR -Rohn , .b . _ __. L Division of UNR. Inc 6 T I TLE USE o.1EQSrLE /-31NGLE P NCHOR.RO TURN6UCKlE SAFETY 1JlETNo THIMBLE WREN VS1NQ PRE'mg wb ClhALE CUmAPS _ FILE NO. . •' THIS DRAWING IS THE PROPERTY OF ROHN IT l NOT T 8E R n /� REPROU UCED, COPIED OR TR A IN W OR IN PART NOT. /5 Q!/E TO V,9 /ARLES /NkOL v1 IN .POOP / ND OT//ER /NSTf�.'L /'T /OIVS, LT �fL/7Lz f WIT OUR WRITTEN = CONSENT. MOM ET / /E C/JTOAIEEPS OR /NSTALLEL 'S RESPONS /B /L /TY TO /0.eov/DE W , Y /� UNLEf! OTHERWISE fPEGIPIED OIMENfION1 ARE GIVEN IN :7.P1/CTUe/'LL•�' . 944 Y U/9TE SUP.oc,e73 FOR �o /ER 5ef7Nnvae CONNECT /OHS. /T , ,3 _l�� IN — - - - .HE� G,e /NSTALLE.P TO.5- ECL/.ee- °••. ozi isilp4 OTHER • DWG. NO. a1//Y BENECESS�'�'�' :° _•. * . °I• T B 6ao3?A BPS 7.-/. SZAWCE OF/LLGLAL ENG //VEEiP /'O DLTE,P/YJ /iYE Tf///T /N•rTALL/LT /Oi —.ilk ° ^ 4 ' - °' J I • G'D/Lff' /E 11////./ LOCf�L BZ//LQ /�G CODE•1' c w ROHN (Descrptio ( Part# . wei lv\z(_z, 3/8" x 4' copper clad ground rod with clamp GR384 160/100 i 3/8" x 4' galvanized ground rod with clamp GR384Z 172/100 3/8" x 6' copper clad ground rod with clamp GR386 235/100 3/8" x 6' galvanized ground rod with clamp GR386Z 258/100 /o ff . . 5/3" x 8' copper clad ground rod 340020 800/100 5/8" x 10' copper clad ground rod 340021 1045/100 3/4" x 10' copper clad ground rod (THD) 340024 1500/100 5/8" x 8' copper clad ground rod, plain end, w /grnd. wire clamp GR8C 82/100 5/8" x 8' galvanized ground rod with ground wire clamp GR8G 90/100 3/4" x 10' copper clad ground rod (THD) w/ ground wire clamp GR10C 133/100 4 3/4" ground rod coupler 3/4C 80/100 7/8" x 6' solid aluminum lightning rod LR 4 5/8" x 5' solid copper lightning rod LRC 6 3/4" x 6' copper clad lightning rod LRCL346 8 1 - 5/8" x 8' copper ground rod 1 - brass rod clamp 10 lbs BGK Base Grounding Kit consisting of: 1 - brass tower attachment lug w /hardware 10' - #4 solid copper wire BGKE Base Grounding Kit consisting of: 1 5/8" x 8' galvanized ground rod 1 S58 rod clamp 10 lbs 1 - tower attachment lug w /hardware 5' - #6 solid copper wire I AGK Anchor wire grounding Kit 3 - 5/8" x 8' copper ground rods 3 - brass rod clamps 30 lbs 1 for 3 anchors - consisting of: 9 - guy wire ground clamps 45' - #6 stranded copper wire AGKE Anchor wire grounding Kit 3 - 5/8" x 8' galvanized ground rods 3 - S58 rod clamps 30 lbs for 3 anchors - consisting of: 9 - guy wire ground clamps 45' - #6 solid copper wire BGK or BGKE 1 BGK or BGKE_, Anchor bolt must s BGK or BGKE BGK or BGKE Attacrt h h to J b e�m I I bok M damp ground wl prov!ded; ro to b ch to lea � nt{ who oronlder: attach Ath rats bort lt If be end If ahachmem lug provided attachment lug provided pd nut omitted Ground lug rl n " G (o provided) Ground wire Ground win l edrechment lug . i Wq Copper \W : (No. 4 } '' MI ra - Copper wire I Copper who �DPKe� (No. 4 max) r { (No. 4 man ) Ii 4 mac) r' 8'min. min. � Ground rod clamp %gwx` 1 Ground rod clamp ^ n in Ground rod Limp Ground red CINnp Ground rod Ground rod I Ground rod I Ground rod I supporting towers and No. 25, 45, and 55 towers No. 25, 45, 5 3w with tapered pe No. 65 and J towers with ta- ed Self su pp g t with anchor bolts with flat base base pered and D towers with tapered grad base guyed towers wi AGK or AGKE s. Comp No G wire Sirs 840020 area thru ur s4oc : 9,hadxuL4• 9042 : » enl 1' (ea lrKalhdon detail Be01367) _ I . (No. 4 roar.) -., . NW Ground rav A Ground rod eV 1 15 Form No. 88- 2200-1583 Page 1 of 1 • 0 041CAi'o � jFC) C PU BLI NOTICE y �Q FEDERAL COMMUNICATIONS COMMISSION 1919 M STREET N.W. WASHINGTON, D.C. 20554 News media information 202/418 -0500, Fax -On- Demand 202/418 -2830, Internet http: / /www.fcc.gov or ftp.fcc.gov April 5, 1996 FCC POLICY FOR HANDLING COMPLAINTS OF INTERFERENCE TO HOME ELECTRONICS EQUIPMENT Each year the FCC receives thousands of complaints of interference to televisions, radios, audio systems, telephones, and other home electronics equipment. In most instances the FCC cannot resolve the problem because the cause of this interference is the design or construction of these products and not a violation of any FCC rule. To help consumers deal with these interference problems, basic information concerning interference solutions is now available on the Internet through the FCC Compliance and Information Bureau Home Page. This basic information includes the CIB Interference Handbook and the CIB Telephone Interference Bulletin. The CIB Interference Handbook includes a list of equipment manufacturers who provide specific assistance with interference problems. The list also is available through the Commission's Fax on Demand at 202 -418- 2830. Callers should request document number 6904. Involving dealers and manufacturers in the resolution process should give them knowledge of the problems and provide both the opportunity and incentive to protect their products through customer service. At the same time, however, it should be emphasized that the Compliance and Information Bureau will continue to take appropriate enforcement action where it has been determined that the interference is caused by violations of the Communications Act or the Commission's rules or policies. For further information, contact Compliance and Information Bureau at (TOLL FREE) 1 -888 -CALL FCC. - FCC - http://www.tcc.govictb/Public_Notices/heeel.html 1/29/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP JR� 00 Date Requested 7//2164 AM PM BLD Location fm qC 544 // Suite MEC Contact Persons �2c��/ -� _ Ph PLM Contractor Ph SWR BUILDING Tenant/Owner j c) ELC ( g Wall ELR F o rn Access: ndation FPS Ftg Drain SGN Crawl Drain Inspection Notes:, v � /0Q �� Slab SIT �A j Post & Beam Ext Sheath /Shear G/ S .6,4e6 Int Sheath /Shear (f Framing Insulation Drywall Nailing I, — S 6 s7£ /9C ^J f ee-€0 J»JC.E W . tom, Firewall Fire Sprinkler i•lE 7 qz /G-03 Fire Alarm Susp'd Ceiling f � Roof GI( ., �A�CZS fad �i/'LuGBTU . C knpArar Misc: _ ` Final , SA ' P ASS PART FAIL D C-Q U! eA.0 PLUMBING Post & Beam Under Slab ClVe,- . _ I (4. /AA �, - � Top Out Water Service " 1 A/ds - tau. pxorJIDE' C.z7P `/` AV Ito l , Sanitary Sewer [� Rain Drains Final � � // PASS PART FAIL 41 L , A 1` /V ' -4 '1J3 / - >46 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: [ ] able to inspect - no access ADA Approach /Sidewalk Other Date Vii/ Inspector /qt Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 04/05/2000 Activities for Case #: BUP1999 -00444 7:36:41 AM Assigned Hold Updated , Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes BUPA005 Application received 10/04/1999 BON RECD No Hold DEB 10/11/1999 BUPA010 Permit created 10/11/1999 DEB DONE No Hold DEB 10/11/1999 BUPA020 Check for parcel restrictions 10/11/1999 DEB DONE No Hold DEB 10/11/1999 BUPA030 Plans routed to PE 10/11/1999 DEB DONE No Hold DEB 10/11/1999 BUPA045 Plans appproved by PE 10/12/1999 RDP DONE No Hold RDP 10/12/1999 BUPA050 Apprvd plans routed to DSTs 10/12/1999 RDP DONE No Hold RDP 10/12/1999 BUPA800 Misc. Inspection 10/12/1999 10/12/1999 NOTE No Hold RDP 10/12/1999 Inspect tower in accordance with approved plans and engineering. BUPA870 Final Inspection 10/12/1999 10/12/1999 02/02/2000 RB PASS No Hold AKJ 02/02/2000 BUPA055 DST Post - Review Completed 10/18/1999 BON DONE No Hold BON 10/18/1999 BUPA075 Ready to issue 10/18/1999 BON DONE No Hold BON 10/18/1999 BUPA085 (F) Issue building permit 10/18/1999 BON DONE No Hold BON 10/18/1999 BUPA610 Footing Insp 11/01/1999 11/01/1999 11/01/1999 RB PASS No Hold RB 11/01/1999 As per engineering details. BUPA950 Case Finaled 02/02/2000 AKJ DONE No Hold AKJ 02/02/2000 Page 1 of 1