Permit C ITY OF TIGARD MASTER PERMIT
PERMIT #: MST2006 -00233
�� �� fit. DEVELOPMENT SERVICES DATE ISSUED: 9/27/2006
�" y' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S114BA -05800
SITE ADDRESS: 16530 SW GREENLAND DR ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.2 LOT: 082 JURISDICTION: TIG
Project Description: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thier own permits per Dan
Nelson of Integra remodeling
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 63 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE: 65,000.00
OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 63 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: W00DSTOVES: 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: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601tamps- 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:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL fi SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
JACK & JUD DICK INTEGRA REMODELING & CONST. INC. applicable laws. All work will be done in accordance with approved
16530 SW GREENLAND DR 7982 SW CIRRUS DR plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97224 BEAVERTON, OR 97008 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
Phone: 503 - 495 - 5193 Contact #: FAX 971 327 - 8176 of these rules or direct questions to OUNC by calling 503 - 246 -6699
PRI 971 223 - 5742 or 1 -800- 332 -2344.
Reg #: LIC 165554
TOTAL FEES: $ 956.43
REQUIRED ITEMS AND REPORTS
Issued By : - ? Z Permittee Signature p _ am
C
7 / °'
- -. _
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.
Building Permit A p ' ><o
(� j rr � '.A_- FOR OFFICE USE ONLY
City of Tigard t '� Recei � /'
Date /By t4 7 (/ 6 �� Permit No�i�� \ 6 'r
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev
w 1 i.
Phone: 503.639.4171 Fax: 503.598.1960 Au O il -• 2 azndi l\
l Dale/ C t ' o 0 0 (Q ��77
C Q( Other Permit:
G (...• �w 1 1
Inspection Line: 503.639.4175 �_J_�_ �, e` I.. Date Ready /By: luris: El See Attached Checklist for
Internet: www.ci.tigard.or.us �. ; \i ��; � °I� Notified /Method �lJ / � I �r Supplemental Information
" - giro OF WORK . ' . REQUIRED DATA: 1- AND 2- FAMILY DWELLING
•
❑ New construction ❑ Demolition - Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION, .. work indicated on this application.
K - and 2- family dwelling ❑ Commercial /industrial Valuation: $ (D r t
El Accessory building ❑ Multi- family Number of bedrooms: r �
❑ Master builder ❑ Other: Number of bathrooms: OS I D.
JOB SITE INFORMATION AND LOCATION « , Total number of floors: i
Job site address: 1 U)5r0 S \N" ele l 01 .-. New dwelling area: CO 3 square feet
City/State /ZIP: T\ 9( c31-1`)-2--L\ Garage /carport area: N /P square feet
Suite /bldg. /apt. no.: J Project name: U I C K / ti c k d, Covered porch area: j (DS square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CFIECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
. _j DESCRIPTION OF WORK • . .
6 Ci work indicated on this application.
a 1vCov � i�itzA lc�n Z° Mt -8 -ei Valuation: $
Existing building area: square feet
New building area: square feet
(PROPERTY OWNER El TENANT • Number of stories:
Name: \ J a CY-- a ) lA i c p \ C \'- Type of construction:
Address: I (p S 3 p S Y' 1 ' 7'f n 1 a Y DY. Occupancy groups:
City /State /ZIP: T \ J Q Op_ qi Existing:
Phone: (j)L{ bl0'7
Fax: ( ) New:
I=1 APPLICANT . • ONTACT PERSON NOTICE
Business name:‘ gM �„ d- r `,r\ All contractors and subcontractors are required to be
Contact name: Dan 1 tl l'y--) licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: ``�� applicant is exempt from licensing, the following reasons
3 V
apply:
(TA ) 2`�, Fax:: ( )
E -mail:
CONTRACTOR ' '; '• , .,
Business name: \ r , / � � �Yu .,,,,„, , (bY \ 1 1 x , BUILDING PERMIT FEES* •
• Q (;7
Address: • > u a -
VV l. - \ ` Please refer to fee schedule.
City/State /ZIP: a'c_' fl ��� q - imr7
{ / 1 y� Fees due upon application
OZC,s- G6
Phone: (Gil �Z - Fax: f l/) - L ! - 7 - Z�� LL
CCB lic.: 1 �G✓. S (J 5",3--5(1 Amount received ! 1
! ' Date received: ?-- `A
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 670c L Ai S -tom Date: - .. p t„ * Fee methodology set by Tri- County Building Industry
T Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
Au6.29. 2006 212PM CLEAN MATER SERVICES 603 681 4439
No .4383 P. 1
. .
- '71_1 - 1F, - i\ - )
A 2 2006 J
CWS Fi Numbed 06 00 ‘2,630 1
CleanWaterCIV1C= sensitive Area Pre - Screening Site Assessment
()ter commitenent it' cictir.
Jurisdiction CI p 'r - fit, c» Date giZz(p4
Tax Map & Tax Lot q A ii 4 4 , 9 , A r7 fr $b O Owner Jse_.le.k. 7 Y pi c.k.
.2 44 R. 11 4reiST7 Applicant `T a Ne t Se n
Site Address 165 Lqi a!t0n /tn . Ar Company Cn 'C9r4 Re 1pdc1in0►
Address 1413 SUJ r.t re-ttc UP':
City State Zip ?, moo. a pg 9 pop$
Proposed Activity Ivy" � model Phone q,(.. x,23.5 'I
a �,� Fax ill T l76
By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges
and agrees that employees of Clean Water Services have authority to enter the project site at all
reasonable times for the purpose of inspecting project site conditions and gathering information
related to the project site.
Official use only below title line
pyrlrrlal Ise only below fhle line Official use only below this line
Y N NA Y N NA
Sensitive Area Composite Map Storater Infrastructure maps
F2 ❑ ❑ mw
Map ,� n ®
nQs# w , _ _
El E Locally adopted studies or maps Other /
RS Specify ® j Specify "9464 /Lima'
Based on a review of the above information and the requirements of Clean Water Services
Design and Construction Standards Resolution and Order No. 04-9:
LI Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST
PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER. If
Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural
Resources Assessment Report may also be required.
Pi Sensitive areas do not appear to exist on site or within 200' of the site. This pre- screening
site assessment does NOT eliminate the need to evaluate and protect water quality
sensitive areas if they are subsequently discovered. This document will serve as your
Service Provider letter as required by Resolution and Order 04-9, Section 3.02.1. All
required permits and approvals must be obtained and completed under applicable local,
state, and federal law.
El The proposed activity does not meet the definition of development. NO SITE ASSESSMENT
OR SERVICE PROVIDER LETTER IS REQUIRED.
Reviewer Co ents:
Reviewed By: __., Date: i y,z li46
#ot . Official use only
Pose
Post -it" Fax Note 7671 SEMI Returned to Applicant
To or is-t, for From (14 J 13",44.„, Mail _ Fax K Counter
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co epe. Co. Date 9> _ r otr By
Phone # Prone ri 5 . 0 , _ 6 ; r too
Fax #
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F.E. FIRE EXTINGUISHER `R U' OVERi1EAD D009
DR/ F.E.C. FIRE EXTINGUISHER CABINET OPG OPENING WWF WELDED WIRE FABRIC
FIN. FINISH OPP. OPPOSITE
F.F. FINISH FLOOR 7 MARK INDICATED APPLIED
FLR FLOOR P•I-PM PLASTIC LAMINATE ON, OVER, OR IN
PMJF PREMOLDED JOINT FILLER @ AT
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-- 16530 SW
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GREENLAND DR.
TAX ROLL: 2S 114BA05800
20'_0'
FRONT YARD
SETBACK I
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t17�.0�, / RESIDENCE' r' � o, .
... AREA TO BE ENCLOSED -- '
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CITY OF -
BUILDING DIVISION
PERMIT #: tvIST2006.00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/27/2006
Phone: (503) 639-4171 4 , 11 41101Pil#
Inspection Requests (24 Hrs.): (503) 639-4175 ..AN■
INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:00AM PAGE:
SITE ADDRESS: 16530 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKE', LANDING 140.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: DICK
DESCRIPTION: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thies own permits per Dan Nelson
of Integra remodeling
OWNER: DICK, JACK & JUDY PHONE #: 503-495-5193
CONTRACTOR: INTEGRA REMODELING & CONST. INC. PHONE #: 971-223-5742
Inspection Request Scheduled For: Date: 3/2612008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 067354-01 971-221-8223
rr tions/Comments/Instructions:
7 = 77 ; e / — '7 El C., 20ZYG-- O° /6
--1 / /Cr
0 PAS 0 PARTIAL APPROVAL fl CANCEL fl NO ACCESS
FAIL OCALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: 0 Phone #: (503) 718
CITY OF ��mm m n.�m mn���mn���
BUILDING DIVISION ' ' PERMIT
~�~~^~~~~""°~" ~~"°"~~"~~"~ #� kAST2006'00233
13125 SW Hall Blvd., Tigar . OR 97223
DATE ISSUED: 8/27/1000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503 ) 639-4175
INSPECTION WORKSHEET FOR DATE: 11y17/2006 TIME: 7:01Am PAGE: 63
- ����r�/^
SITE ADDRESS: 16530 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: DICK
DESCRIPTION: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thier own permits per Dan Nelson
of Integra remodeling
OWNER: DICK, JACK & JUDY PHONE #: 503435.5193
CONTRACTOR: INTEGRA REMODELING & c0NaT. PHONE #: 971'225-5742
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 0399213-01 971'221'8223 M
Corrections/Comments/Instructions:
•
`'
n PARTIAL APPROVAL . CANCEL 0 NO ACCESS
n FAIL CALL FOR INSPECTION ' 0 ADDITIONAL FEES ASSESSED
Inspector: Date: [7/0 Phone #: (503) 718- 1 7_
_- ' _ _
CITY OF TIGARD •
BUILDING DIVISION • PERMIT #: MST2006-00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/27/2006
Phone: (503) 639- 4171�� @�iigj�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/13/2006 TIME: 7 :04AM PAGE: 108
SITE ADDRESS: 16530 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.2 LOT #: 0132 TYPE OF USE: •
PROJECT NAME: DICK
DESCRIPTION: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thier own permits per Dan Nelson
of Integra remodeling -
OWNER: DICK, JACK & JUDY PHONE #: 603.495-5193
CONTRACTOR: INTEGRA REMODELING & CONST. INC. PHONE #: 971 -223 -5742
•
' Inspection Request Scheduled For: Date: 11/1312006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 039570 -01 971 -221 -6223 Y
Corrections /Comments /Instructions: c7i
f1 -wmti S Anic .l;lne�
�� / /t - a c://. 0, k . ;S4 LA
r7Z y � � /t � .ia �P*r�N c. r
D7 Fg.ixiv∎ - N4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: PIAV Date: V3 /0( Phone #: (503) 718- �1 ��
CITY �~�����U��������
��nm m ��m mu�m��nn��
BUILDING DIVISION DIVISION .
PERMIT #: . .
MST2006
13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 9V27/2806
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 a��� IL
INSPECTION WORKSHEET FOR DATE: 1002006 TIME: 7:03A&4 PAGE: 26
SITE ADDRESS: 1GG3DEW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NQ.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: DICK
DESCRIPTION: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thief own permits per Dan Nelson
of Integra remodeling
OWNER: DICK, JACK & JUDY PHONE #: 503-496'5193 '
CONTRACTOR: INTEGRA REMODELING & CONST. INC. PHONE #: 971-223-5742 '
Inspection Request Scheduled For: Date: 1002006 Pour Time: 10:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 037809-01 503-784-0632 Y
Corrections/Comments/Instructions:
-
| PASS U PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
n FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: , �� Date: /e— --06 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006 -00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/27/2006
Phone: (503) 639 -4171 % 7p1 11 4 1 46 '�le�
Inspection Requests (24 Hrs.): (503) 639-4175 :_�
INSPECTION WORKSHEET FOR DATE: 1016 TIME: 7 :03AM PAGE:
SITE ADDRESS: 16530 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: DICK
DESCRIPTION: Addition & kitchen remodel, Structural Work ONLY, Subs must pull thier own permits per Dan Nelson
of Integra remodeling
OWNER: DICK, JACK & JUDY PHONE #: 503 --495 -5193
CONTRACTOR: INTEGRA REMODELING & CON ST. INC. PHONE #: 971-223-5742
Inspection Request Scheduled For: Date: 10/612006 Pour Time: 10:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 037809-02 503- 784 -0832 N
Corrections/Comments/Instructions:
ins. . 41 A/ 5. ZE % SP¢ c. , ,
•
P ASS ❑ PARTIAL APPROVAL l CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Date: 7d— Phone #: (503) 718 - Z- �'
CITY OF. TIGARD ,
BUILDING DIVISION PERMIT #: MST :rat'S-0
- A, 4, p
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: !271?OOt:
Phone: (503) 639 -4171 4 Iu it
Inspection Requests (24 Hrs.): (503) 639 -4175 ., I � ..
INSPECTION WORKSHEET FOR DATE: 4/3012008 TIME: 7:Q£f,It PAGE: 9
SITE ADDRESS: 1i, /; x) SW Cit?l:,i::.Nt.r tND OR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: Oft,K
DESCRIPTION: Addition & t.Etr.$t .rd e.:inodei, : ti,::$ttra i't:tikel /1.Y, Suh nt Ft. pul:1 thief ti .vn F :e!mit.F.: pc f>an Nelson
of i:itc:Ijr . &iNTIcAieling
OWNER: '1iC 14. JACK R. JUDY PHONE #: 503-495-5193
CONTRACTOR: IN I EGR + , i?f.'_Nic.'e?i'.t-IN G 's, C014 INC. PHONE #: / 1.223 ':f742
Inspection Request Scheduled For: Date: ' /3OiaOU8 Pour Time:
Code # Inspection Description Confirm # Contact # Message
,i -39 Final ini.poiion OG1'.1093.EJi 971-221 -82l?.3 Y
Corrections /Comments / Instructions:
1
1
ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
U FAIL I I ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED •
Inspector: Date: — TO — a 8 Pho #: (503) 718- -4-Q-