Permit CITY O F TI GARD MASTER PERMIT
PERMIT #: MST1999 -00228
lei DEVELOPMENT SERVICES DATE ISSUED: 7/12/99 •
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6C1-711G
SITE ADDRESS: 10010 SW JOHNSON ST I NA L PARCEL: 2S102BB -01202
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
' REMARKS: Add a 504 sq. ft.second story addtion over the existing attached garage.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 26 FIRST: 504 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
i
TYPE OF USE: SFM FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 70,000.00
OCCUPANCY GRP: R3 BDRM: 2 BATH: 1 TOTAL: sf REAR:
PLUMBING
SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 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 & 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:
Owner: Contractor: TOTAL FEES: $ 1,280.29
N HOME INC This permit is subject to the regulations contained in the
ROBIN WATKINS FREEMAN ROBIN
SW JOHNSON RD FREE A Tigard Municipal Code, State of OR. Specialty Codes and
TIGARD, OR JOHNSON 11742 SE 32 32 , ND D 97222 all other applicable laws. 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 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 #: LIC 77499 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 lnsp Exterior Sheathing Insc Plumb Final
Plumb Top Out Insulation lnsp Final inspection
Electrical Rough In Rain drain lnsp
Framing Insp Electrical Final
Shear A - • Mechanical Final
- /
lf, Iss ed B 4 / I
By : i _ L I.:� � - _ . .. J!. _�_i , Permittee Signature : �, _tom • l._
or
- Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next b s day
IIIP
CITY OF TIGARD Residential Building Permit Application Plan Chec # (6- 7P
13125 SW HALL BLVD. Additions or Alterations By /V
Date - •/` •
TIGARD; OR 97223 Single. Family Detached or Attached (Duplex) Date to P.E.4 ?'
V 503 - 639 -4171 Date to DST C, -JIM
F 503 - 684 -7297 -M P rmit # ni F7 - " 71)'
Print or Type Called 6 //
Incomplete or illegible applications will not be accepted Y/14 /)
Name of Project 1)U W Nam /A
Job Wyk v1, l hell Q Fr fi � 17t* ArrA lteci
Address /`� Architect Mailing1AWe,s H Ake, )1Ny tirVs 1 A to )k," 1 City / II toU / b �� Zi 2. Na r Y 19 /14 u I45 - u/l "I� Phone
L2Z 553 • 94.5,6 •
Owner Mailing Addres Name •
i 10010 c) d1l/ it F U� Engineer Mailing Address
Cityja�tatavrl or - zz g�'�1.+U3�" g
� !! /I City /State Zip Phone
General Name V
��1 / �,� ,� /�
Contractor t i rte)( �Tv' ` f - s ( `e___ Describe work New 0 Addition 0 Alteration 0 Repair 0
Mailing Address to be done: 11
•
Prior to permit Additional D cription pff Work: .}1`jlt'i
issuance, a copy City /State Zip Phone 20i 'Oar S ! f tOv1 e P ( /1 a 1/141410
of all licenses /
are required if Oregon Const. Cont. Board Exp. Date PROJECT
• expired in C
e OT Lic.# / -) L-F0 /_ z l? VALUATION $ i 74C6)O
Mechanical Na e NEW CONSTRUCTION ONLY:
Sub - c. l'tiY \A(1/CA(1A1 Sq. FA Hoys i -�. - Sq. Ft. Garage ..
Contractor Mailing Address �+ '''t 4 l .5 gdAl 11011 _
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 5bkd6
are required if Oregon Const. Cont. Board Exp. Date Energy System )4 Alarms
expired in COT Lic.# I /1� / / / S D / Installations Vacuum Irrigation
database (J System System
Plumbing Name (check all that Other: i .
• Sub- G ( �I II im vet apply)
Contractor Mailing Address • • Corner Lot YES NO • Flag Lot YES NO
(check one) (check one) V
• Has the Subdivision Plat recorded? N/A 5E NO
Prior to permit City /State Zip Phone
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date b . 1r i/ I j((, rr ��� ` b 14
required if Lic.# rtb
expired in COT 1 - N> I ) 0 �9 -1 -0) I hearby ack owledge that I have read this application, that the
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
- I P3 61 - ;ill " l / � q Oregon State
Name . ' I Sigt t n Agent, ` L Date / }
Electrical ��2 V 1 \ ICAQ f l
• tai �� � '7
Sub- Mailing Address Cont ct Person - ZD1 � � Phone #
Contractor ` " fi,
City /State Zip Phone �" �ttC
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.#
j Plat #: Map/ #:
expired in COT J 5S 7.5( zi236 - 12
database Electrical Lic. # Exp. Date S acks: Zone: > / Solar
Zl0 ' t 1 ;'5 J��
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF.
ZS iyS
• V..4 is \dsts \forms\sfaddalt.doc 11/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 1 9 9 00
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 11 ( g ' AM PM BLD
Location 100/0
Suite MEC
Contact Person Ph 7 / ED-[ C PLM
Contractor Ph SWR
�`.l Tenant/Owner ELC
Retaining all 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:
�; PART FAIL
P MBING
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 \ 1
Service VV
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 1 Inspector
Other Ext
Other
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site.