Permit •
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST99 -00118
An DEVELOPMENT SERVICES DATE ISSUED: 4/9/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 .
SITE ADDRESS: 11945 SW KING JAMES PL PARCEL: 2S115BA -01300
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
REMARKS: Enclosure of existing 12' x 24'4" concrete patio slab to convert to family room addition.
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 12 FIRST: 288 sf BASEMENT: 0.00 sf LEFT: 5 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 0 sf GARAGE: 0 sf FRONT: 0 PARKING SPACES : 0
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT: 0 •
VALUE: $ 20,056.00
OCCUPANCY GRP: R3 BDRM: 0 BATH: 0 TOTAL: 288.00 sf REAR: 30
PLUMBING
SINKS: 0 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0
LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0
TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 • BCKFLW PREVNTR: 0 GREASE TRAPS: 0
• OTHER FIXTURES: 0
MECHANICAL '
FUEL TYPES FURN < 100K: 0 BOIL /CMP < 3HP: 0 VENT FANS: 0 CLOTHES DRYER: 0
GAS FURN > =100K: 0 UNIT HEATERS: 0 HOODS: 0 OTHER UNITS: 0
MAX INP: Obtu FLOOR FURNANCES: 0 VENTS: 0 WOODSTOVES: 0 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 amp: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR: 0
LIMITED ENERGY: 0 401 - 600 amp: 0 401 - 600 amp: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL: 0 IN PLANT: 0
601 - 1000 amp: 0 601 +amps•1000v: 0 MINOR LABEL: 0
1000+ 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:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: 0
Owner: Contractor: TOTAL FEES: $ 289.06
WESTAR ROOFING + This permit is subject to the regulations contained in the
CONSTRUCTION Tigard Municipal Code, State of OR. Specialty Codes and
WESTAR INVESTMENT CORP all other applicable laws. All work will be done in
2717 SW KELLY #120 accordance with approved plans. This permit will expire if
PORTLAND, OR 97201 work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: Phone: Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg5 127528 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion 844 -8444 Insulation Insp
Post/Beam Struck Rain drain lnsp
Electrical Service Electrical Final
Electrical Rough Ir Building Final
Framing lnsp
r
/ ' /
/ IIJI L
GJF4 -L- (3 1 / 4 7/ ,g5-c5—' 7 -'O 7 Fe-g 'u , — e-o eK// £,9-Y //05/e6 Pe.70
CITY OF TIGARD Residential Building Permit Application Plan Check # 3 -(01 C
13125 SW HALL BLVD. Additions or Alterations Rec'd By
Date � --C
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. -6
V 503- 639 -4171 Date to DST 3 -,2 9- 9
F 503 - 684 -7297 Permit # /-1-1
Print or Type Called i f- 6 -'1.9 10 of w,
Incomplete or illegible applications will not be accepted
Name of Project Name
Job
site Address {� f Architect Mailing Address
Address
I M Mils - 15W �`;o1.)An1e5 PL City /State Zip Phone
Name •
nL7Fid MOW Name
Owner Mailing Address n
/ H �
in GA ioird
I) ity /State ° ! 1 /S S ei� J4-mec "L Engineer Mailing Address
k A G'T Z i y N 7 z 2' Phone g 5.S /S x> liZ
Nam d Zip Phone
General y — ( �,Q 77 LZ t 55
Contractor )S p Ar C/9x)4Trv(7i Describe work ii New 0 Addition a Alteration 0 Repair 0
Mailing Address to be done: Add
Prior to permit 4S �' s / (97" ' Additional Description of Work: -
issuance, a copy ity /State. Zip Phone
of all licenses f r-T � ,-25-------5-00D 4i4Z4b---
are required if Oregon Const. Cont. Board Exp. Da PROJECT
expired in COT Lic.# I 00
/ VALUATION
database . - f �� _ ',/ /`
- Mechanical Name / NEW CONSTRUCTION
Sub- 0 A Sq. Ft. House: Sq. Ft. Garage i
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 Name (check all that Other:
Sub- - Iv A 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 t
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# - -
expired in COT I hearby acknowledge 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
Oregon State laws.
Name .g (ii: ture of 0 e 1 0
Electrical E t y tl ANAL W .. ..- !""e'2. Sub- Mailing Address o ` c' • - son r wile ' • Phone #
Contractor rt5 Ulilli6 ' 7 ?
City /State Zip Phone
Prior to permit .
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: Map/TL #:
required if Lic.# 7
expired in COT oq -5//544 -or 3o0
database Electrical Lic. # Exp. Date S tbacks Zone: Solar:
Electrical Supervisor Lic. # Exp. Date Engin ring pproval: Plann Appr I: TIF:
is \dsts \forms\sfaddalt.doc 11/20/98
KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
MMINNimmmi Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: 4-&- �a714 -2
located at://4
t: / /q ' Ct j KI /11 V AS
King City Representativ
I DSTSKCCENST.DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 9q r coi /
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�' ) G-9 AM PM BUD
Date Requested BLD
CI l
Location I I - 1 1-- rine3 112. Suite MEC
Contact Person Ph 3 17 S S9 PLM
Contractor Ph SWR
el/OIL D I p } a Tenant/Owner ELC
fl°
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:
i.
r 1 PART FAIL
P ° e MBI NGp ;
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
`MECHANICALr"
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICA;L,: = b< "li..;y
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
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 7
Date t 7 / 5 Inspector
Other 7 / ''\ Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.