Permit . ,,,_
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00448
11 DEVELOPMENT SERVICES DATE ISSUED: 9/22/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11756 SW 129TH PL PARCEL: 1S133DD -01600
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 ZONING: R -4.5
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: Installation of 8,000 gallon above - ground swimming pool, with associated electrical and mechanical.
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: FINBSMENT: sf RIGHT:
VALUE:
OCCUPANCY GRP: BDRM: BATH: TOTAL: 0.00 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:
LPG FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: 180,000 btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS 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: SIGNAUPANEL: 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 & STEREOS 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:
Contractor: TOTAL FEES: $ 136.89
Owner: This permit is subject to the regulations contained in the
GRIFFIN, KENNETH R + ROXANNE M OWNER Tigard Municipal Code, State of OR. Specialty Codes and
11756 SW 129TH PL all other applicable laws. All work will be done in
TIGARD, OR 97223 accordance with approved plans. This 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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Mechanical Insp
Electrical Rough In
Electrical Final
Mechanical Final
Final inspection
09 4
•
Issued By : 4 ' r Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
f
•
tlI TIGARD Residential Building Permit Application Plan Check #
' - n error n Recd By
3125 SW HALL BLVD.
TIGARD, OR 97223 Si • - - - . -• • • . - • is. - : Date Recd / 274
\ Date to P.E.
V 503-6394171 �' ) /iy,y - / )-- (I / fi8Z
e 6 IJ) Date to DST
F 503 - 684 -7297 Permit # /ys % 2Q4D 40YY�"
Print or Type i1 Called
Incomplete or illegible applications will not be ac ep� ted
Name of Project r Name
Job 'Slr T T j J Architect Mailing Address
Address Site Ad es �
II S 1 --4t .(
,' Pt_
City/State Zip Phone
Name " i
M ailing A dre s Name
X Owner ) r S W pct / i ' PL
Cttate Zi Pone Engineer Mailing Address
I / S a ..•( c i-a 3 5 3"j-1 OG City/State Zi Phone
General Name
Contractor 4 Describe work New 0 Addition 0 `l eration O Repai
Mailing Address to be done:
Prior to permit Additional Description of Work:
issuance, a copy City /State Zip Phone Sel)/MM/ 1G /9"- ' fit/t` 6n2-/z
of all licenses
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# VALUATION $ Z /67 ,
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub - 0 _ 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 Zip Phone subcontractor in the following areas
of all licenses Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing ame (check all that Other:
Sub- apply)
Contractor Mailing As • ss 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 Zi • Phone
issuance, a copy Solar Compliance
of all licenses are Oregon Const. Cont. Board •. Date (Calculation Attached)
required if Lic.# I hearby 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
' State laws.
Name Signe /rk J` 10 r /A ent 7 fL
Electrical e -WA Mailing Address Contact' a �� i " G G ( -2
S
v% 5L
Contractor FOR OFFICE USE ONLY:
City /State Zip Phone Plat #: Map/TL #:
Prior to permit
issuance, a copy Setbacks: Zone: Solar:
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.#
expired in COT Engineering Approval: Planning Approval: TIF:
database Electrical Lic. # Exp. Date
Electrical Supervisor Lic. # Exp. Date
. 4( / •- e e ,
i:forms\sfintalt.doc (DST) 10/23/98
Permit #: / lD — DD yYd9
• F •
/ �' f,
m • Address:
W \ ' Issued by ate: 7A v2 /�7J
1, 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:
rl 1. I own, reside in, or will reside in the completed structure.
IE 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
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
r Eg 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 OOwners about Construction Responsibilities on the reverse side of this form.
0 5 ))--- 9/ 2 1 0 0
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
r �
- -
~ CITY OF TIGARD BUILDING INSPECTION DIVISION
MST 10 0Ge:i
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�y ,,�/ BUP
Date Requested ' �Z AM PM �j P/'1 BLD
Location L ( 7 s S 1 /Og Suite MEC
Contact Person Ph PLM
Contractor �i , / if/ / ♦ ?� r n Ph 4 11 // 6 6 SWR
BUILDING Tenant/Owner � ,G(,_ ast 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final /,?-737
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
' PASS PART FAIL
MECHANICAL
Post & Beam "*7
Rough In
Gas Line
Smoke Dampers
Final
PA PART FAIL
CTRIC
Service /f
Rough In
UG /Slab
j Low Voltage
're Alarm
"gol • S :ART 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 einsp-ction RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector J Ext
Final
PASS PART FAIL DO N • T REMOVE this inspection record from the job site.
• 'CITY OF TIGARD BUILDING INSPECTION DIVISION 3 (:)
MST L
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
! Date Requested 3 "�Z AM PM BLD
1/ %
Location / 7 ,- C 5 l`' / Z ✓ � Suite M : • •�o ca3 ��
Contact Person Ph J2 , 4-/Z 33 e/ 2 — PLM
Contractor BWR
Tenan Owner )9� cad ,e lei 7 10 ; 4. - ter- ELC
Retaining Wall / �y+ ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab L- r Ni C • Q . 4t1 SIT
Post & Beam
Ext Sheath /Shear "Q
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof � ' �� � aI �
Misc: /'�,il1
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PART FAIL
CHANICACD
Post & Beam
Rough In
Gas Line
Smoke Dampers
C PASS ART FAIL
E ICAL
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 inspectio record from the job site.
MST — Master Permit
4 Inspection Description Date Passed By Notes
Grading
Footing /Setback
Foundation walls
Slab
Footing drain
Waterproof basement walls
Plumbing underslab
Crawl drain
Post/beam plumbing
Post/beam mechanical
Underfloor insulation
Post/beam structural
Shear walls /anchors
Exterior sheathing
Plumbing top -out
Gas line & test
Mechanical rough -in
Electrical rough -in
Electrical service
Low voltage
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall
Framing
MFG -Home set -up
Insulation
Drywall nailing
Masonry/Reinforcement
Rain drain
Sanitary sewer
Water service
Pump /fill septic tank
Approach /sidewalk
Grading final
Mechanical final
Plumbing final
Electrical final - _ eg o CJ
Final inspection 3/21
l 2 l p t
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By Notes
Sanitary sewer
Final inspection
INSPECTION RECORD — MST (MASTER) PERMITS
L
. r • .
/ CITY O ff' TIGARD _ MASTER PERMIT
PERMIT #: MST2000 -00448
7,,,,,-1- �k DEVELOPMENT SERVICES DATE ISSUED: 9/22/00
'•°' ` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11756 SW 129TH PL PARCEL: 1S133DD -01600
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 ZONING: R -4.5
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: Installation of 8,000 gallon above - ground swimming pool, with associated electrical and mechanical.
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: FINBSMENT: sf RIGHT:
VALUE:
OCCUPANCY GRP: BDRM: BATH: TOTAL: 0.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASIN`J:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
LPG FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: 180,000 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 UN Lr: 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 & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
SURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEJIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Contractor: TOTAL FEES: $ 136.89
Owner: This permit is subject to the regulations contained in the
GRIFFIN, KENNETH R + ROXANNE M OWNER Tigard Municipal Code, State of OR. Specialty Codes and
11756 SW 129TH PL all other applicable laws. All work will be done in
TIGARD, OR 97223 accordance with approved plans. This 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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: forth in OAR 952 -001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Mechanical Insp
l
Electrical Rough In O
Electrical Final
Mechanical Final
Final inspection
. it
Issued By : A(&AIII Permittee Signature :" r %1.4A 4111111
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
WPM