Permit CITY OF TIGARD
DEVELOPMENT SERVICES MASTER ,PERMIT
1.E. 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 PERMIT #.... o ..: t+IST96_04 69
DATE ISSUED: 10/22/96
PARCEL: 2511 OCC•- 1670121
SITE ADDRESS...: 12449 SW KING GEORGE DR
SUBDIVISION. , , y,: • ZONING::
BLOCK........,... LOT ..............
Remarks: new roof
new roof
BUILDING ------ - - - - --
REISSUE: STORIES : 0 FLOOR AREAS- - - ---- BASEMENT...: 0 sf REQUIRED SETBACKS - - -- REQUIRED------ -
CLASS OF WORK. :REP . HEIGHT. 0:r ' FIRST, 0 sf: GARAGE......:• 0 sf'.LEFT,..,..,,......:, 0. SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD : 0 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0
TYPE: OF CONST.:5N. . DWELLING-UNITS:: • 0 FINBSMENT:'' • .0 sf RIGHT........,,: 0
OCCUPANCY GRP,:R3 BDRM: 0 BATH: 0 TOTAL - - - -: 0 sf VALUE..$: 0 REAR • 0
____------- __— _— _— __ -7 —__ PLUMBING. - , = - - --- -
SINKS : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES 0 DISHWASHERS,`:,:_ 0• FLOOR DRAINS...: 0 :SEWER.LINE ft: 0 SF RAIN DRAINS:, 0 CATCH BASINS.,: 0
TUB/SHOWERS...: 0 GARBAGE DISP.,: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
--------------------- - - - - -- - - - -- MECHANICAL -- — _--- -____- - - --
FUEL TYPES -- FURN { 100K :.: 0 . BOIL /CMP { 3HP: 0 VENT FANS......: 0 CLOTHES DRYERS: 0
FURN }= 1'" ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS.,.: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 . VENTS.. ...., 0 q WOODSTOVES......: ®• _ GAS OUTLETS.,.,: 0
--------------- — _— __________� -- - ELECTRICAL ---------------------------------- -__�_—
-- RESIDENTIAL,UNIT - -- -- SERVICE /FEEDER ---= —TEMP SRVC /FEEDERS — BRANCH:CIRCUITS - -' - - -- MISCELLANEOUS - - -- ADD',L INSPECTIONS- -
1000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR,.: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
'EA ADD'L 500SF.: 0 -- 201 -.400 amp,.: 0 201 400.asp. 0' - 1st W/0 SVC /FDR :.0, ,SIGN /OUL.LIN..LTr 0 PER. HOUR ., • 0 .
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 asp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1000 amp.: 0 601 +amps- 1000.'V: 0 . .. MINOR LABEL -10: 0
1'e0+ amp /volt.: 0 - --- ----------- - - - - -- PLAN REVIEW SECTION ---- --------------______
Reconnect only.: 0 • - }=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..: • 0TH: BOILER.........:, HVAC..,,....;,...:,. LANDSCAPE /IRRIG: . PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: ..
• ' DATA /TELE'COMM.: . NURSE CALLS • TOTAL # SYSTEMS: 0
Owner: ----- ---- -- - -- Contractor: - -- - ----- TOTAL FEES:$ 55.56
BETTY MAY. • . ... GREG',S QUALITY ROOFING
12449 SW KING GEORGE DR 12245 SW PIONEER LN #D 119
KING CITY OR 97224, . • BEAVERTON OR.97008
Phone #: • Phone #: 503- 590-6148
Reg 41..: 95890': •
This permit is issued subject to °the regulations :contained in, the Tigard Municipal Code, State of Ore, Specialty Codes and 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 work is suspended for sore than 180 days.
------------------------------------ ----- - - - - -- REQUIRED INSPECT.ION5 ------ - - - - -- - --- - -- - - --
Post /Beam Struct• .
Electrical Rough _
Insulation Insp
Building Final
Erosion Control T +'
Permittee Signature: ✓ G,l,t ) Issued Bv: ..1a./.
, „, ,,,. Cal ]. ,far inspect:,ion ,- 639 -4175
., OCT- 07 -'96 MON 02:26 ID: . FAX NO:
,. — 13357 P02
• •
Plan Check #
t;3•1i (F T IGARD Residential Building Permit Application Rees By RA--
Data Recd LO-N-96 13125 SW HALL BLVD. New Construction Additions or Alterations Date to P.E.
'TIGARD, OR 97223 Single Family Detached or Attached Date to Dsr t@ - 1. - 94, 0-i.:36
(503' 639-4171 Date
# ff\ 1 In - DIM # k
Print or Type Called
Incomplete or illegible applications will not be accepted Called I b Cie. IOW
• Name of Subdivision Lot # Name
Job �� S "( Arch M ailing Address
Address Site Address
•
City /State Zip ' Phone
" "�'" Nam
Name
• Owner Mailing Address V
12•-Z 4- [ .AN (The arc-,o Engineer Mailing Address
State • Zip Pnone
N.., _ ' City /State Zip r Phone
/`
Name
General 6y- t ( . ..[7� its I Describe work new 0 addition 0 alteration 0 repair 0
ir
Mailing Address Q to be done:
Contractor +a 44 no S U 1 / w Additional Description of Work:
I ,-CityrStete Zip Phone
i 5 c, we.uvo ,0 ”0-(p( .
Oregon Gong. Cont. Board l.ic,# E xp. Date —" p ro act !�
Attach Copy of e) ce,01 0 l l l lQ CO
Current COT Business Tax or Metro # Exp. D Valuation ate , —
Ltaenaes NEW CONSTRUCTION ONLY: •
Name Sq.Ft. House: Sq_Ft_Garage:
Mechanical
Sub Mailing Address Corner Lot Yes No Flag Lot Yes No
Contractor (check one) (check one)
City/State zip Pnone Restricted Audio/Stereo Burglar
Oregon Coast. Cont. Board Lic_iF Exp. Date Energy System Alarm
Attach Copy of - Installation Garage Door HVAC
.Current COT Business Tax or Metro # Exp. Date Opener Systems
Licensee
Name (check all that Other:
Plumbing apply) •
Will the electrical subcontractor wire for all Yes No
Sub Mailing Address restricted energy installations?
Contractor Has the Subdivision Plat recorded? I NJA Yes No
City /State Zip Phone
R of MST# Solar Compliance
Oregon Coast Cont Soard l lc.# Exp. Date (Calculation, Attached) _
I ptl Cu Copy of rrent Plumbing Lic a: Exp, Date I hereby acknowledge a that I have read this application, that the
Cu information given is correct, that I cm the owner or authorized agent of
I Licenses _
COT Business Tax or Metro # Exp. Date the owner, and that plans submitted are in compliance with Oregon
State laws,
Signature of Owner/agent Date
Name
Electrical Contact Person Name Phone
{ Sub- Mailing Address
Contractor FOR OFFICE USE ONLY: .
City /State Zip Phone Plat # Map/a#:
i Oregon Coast, Cant Board Lie.# Exp, Date SolaC
Attach Copy of Setbacks Zone: f
Current Electrical Lic. # Exp. Date
Licenses
COT Business Tax or Metro # Exp. Date Engineering Approval: Planning Approval: TIF:
• dsts\rnatapp.dec
OCT- 07 —'96 MON 02:26 ID: FAX N0: #357 P03
•
• j "11 4,1
Permit # Account Description
rm Amount 611t-ad, Bag_ Due
MST. Permit (BUILD) 5,a 0 3
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT)
State Tax (TAX) , 53
Bldg:
Plumb: •
Mech:
ELCIELR:
Plan Check
• MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Erosion Control Permit ( ELPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS: S J =
1 :ddstslmst2pp.dOc
•
. Rev. 7196