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Permit
, tf CITY OF TIGARD PERMIT #EFtMIT ° MS COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/0- - 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 - PARCEL: ES 1 1 OCC -17400 SITE ADDRESS...: 12471 SW KING GEORGE DR SUBDIVISION ° ZONING: BLOCK. ° ° ° ° ° °...° LOT ° � Remarks: 250 SQ FT ADDITION WITH 30 SQ FT REMODEL PATH I - -- .BUILDING -- REISSUE: STORIES • 1 FLOOR AREAS- - - - - -- BASEMENT...: 0 sf REQUIRED SETBACKS - - -- REQUIRED -- CLASS OF WORK.:ADD HEIGHT • 13 FIRST • 250 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0 TYPE OF CONST.:5 -1HR DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT • 10 OCCUPANCY GRP.:R3 BDRM: 0 BATH: 1 TOTAL : 250 sf VALUE..$: 18000 REAR • 36 - --- -- - - - -- PLUMBING - - ---- SINKS • 0 WATER 1 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES • 1 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 -- ----- -- - - - - -- MECHANICAL ----- — - -- - - - -- FUEL TYPES---- -- - - -- FURN (100K ..: B BOIL /CMP ( 3HP: 0 VENT FANS • 1 CLOTHES DRYERS: 0 /GAS/ / / FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 2 W00DSTOVES : 0 GAS OUTLETS...: 0 -------------------------------------------------------------- ELECTRICAL -- - - - --- -- RESIDENTIAL UNIT -- -- SERVICE /FEEDER - - -- - -TEMP SRVC /FEEDERS -- - -- BRANCH CIRCUITS - -- - - -- MISCELLANEOUS - - -- - -ADD'L INSPECTIONS- - 1000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 asap..: 0 W /SVC OR FDR..: 1 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 asap..: 0 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR • 0 LIMITED ENERGY.: 0 401 - 600 alp..: 0 401 - 600 aep..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0 MANF HM /SVC /FDR: 0 601 - 1000 aep.: 0 601 +asps -1v40 v: 0 MINOR LABEL -10: 0 1000+ asp /volt.: 0 ---------------------- - - ---- PLAN REVIEW SECTION — ------ --- - -- Reconnect only.: 0 ) =4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC: -- ------------------------------------ ELECTRICAL - RESTRICTED ENERGY ------ - - - - -- A. SF RESIDENTIAL- B. COMMERCIAL — - AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: :: HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL # SYSTEMS: 0 Owner: --------- - ----- -- --- - -- Contractor: - -- TOTAL FEES:$ 312.96 BARBARA GEER DOUGLAS DOERING CONSTRUCTION 12471 SW KING GEORGE 6005 SW 130TH AVENUE KING CITY OR 97224 BEAVERTON OR 97m7 Phone #: Phone #: 626 -8629 Reg #..: 97117 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 more than 180 days. _________________________________ --------- REQUIRED INSPECTIONS --- Footing Insp PLN /Underfloor Shear Wall Insp Electrical Final Foundation Insp Mechanical Insp Low Voltage Mechanical Final Post /Beae Struct Plumb Top Out Insulation Insp Plumb Final Post /Beal Mechan Electrical Servi Gyp Board Insp Building Final Crawl Drain Framing Insp Rain drain Insp j �— • �� e r m i t t e e —S i g n.a -t �r r e° __ I s -s sued B y: '.- / I ( -/'�i.`wl.d. Call for i s p y ection — 639 -4175 I. • Residential Building Permit Application .,- . . City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Address: /0'17/ /r/d' ( .. . .. „...., .. .,. ,..:„..:.:,.. - . - • , • . - • ..... - .... - .. Office Use Only Subdivision: Lot # Planck/Rec # 0 5 ) ' ' • • :i.'" ,, ° t9 / :7-. r . : , / Valuation: /j • / -7 Permit # z.A . . - s - .t74 , -= (),33 Corner Lot? Y N !RECEIVED ..., - .... : :,.. ,..•- . . . .., :,::: : , ::,..:::::: .: :, ..:.:: ..,, :, ,,,,,, . • : : , . . , : ::: ,„: :::,.,:„:..,.: , :„,, , „ :. . .,, '...ReissLielOf ... :,, . ,,,, •:•,-,• , • . ., . :., Flag Lot? Y N JUL 9 •-: - ,I.:•-5(10CC.7 7 V , 0-. • • .. MapATL pr • , • ."1.....:-.::: • . , CUftiviuiii ii aVELOPMENT Owner: SL) & ' :::- ApprOva Is: Re LciihjA . . Address: 2 - Z 1-7/ e' "16 . . Pannin ;' 1:1 • tk):' ' .' :::, 1 .... .:. / 14 .1 4 ' 17 / Engineering - NI - • - Phone: :,:-: Oth 1 er: : ,,,,_:: . •-, . : . :-- . . : -i' IO .:-::::::ii ' :!: ' ' '' ;i- •:' 1. ' 1E ' l! ' '.- P :: ' : : T :- - i :: :''': . .,., . . . . . . . .. . . • • • ... . . . ._ , .. ._ . . . . ., . ... . (-- , ) . ..• •••• ., . . ,., . • ... —.... „„, ,.. .: .: „.„... . . .. .„ . . . .. - - • - - ,• • . ,, .... „ .. . ,,. „.„. „ Contractor: / _4(9./7.--ie/)/7 6p-7.5/ • . . . : . . . .,. ., . .. „. , . .. • .• _ „ „ .. .... „. ., . ..... „ ,• Items Reauired ---- . Address: 00V S f-- _ce.-.4.-) / .?(*) fr. L.L- bc SUontraCtorS-.:: .,,,,,:••••::.- z . : ••••-,:.::::, .......,,,,,, ....„ . gffrei,ve,,et-Diri 4 4 Detail -, - • • . . . ,.: / Phone: ,5 (2 6. - '92 . ' Other: --• ... • , Contractor's License # 9 . 71/ o. 2/22/q /attach copy of current Oregon ficense) • / ( 26 f Contact Name & Phone. • d'e /, } Subcontractors: • Architect/Engineer: ) ag/Z/ , ? 7 lt/ Plumbing),,,, -, -- $2 1 / 3 Ott' 5.4".1-12e, 01VMech(aatinaiccahl•cg_p.L____. r copy .-- - 4' Current 1 R Contrac or's License) Of/ - b 1 Phone: CL- 4 eyisI ,) (0 2O8, JOB DESCRIPTION: f /Gi7 (AilLt;teA4 to CO Ail 4" -6 ...e4a.:41 , t 1 , • Ai / - .02. ......---. a, .42,6 0 6 -(-0 -4\W etcuri -- ; z , --... Applica t Signature & Phone number Received by: R , via",_, Date Received: 6— 26-94. 7 £0,6 O7/?G f o/(-- - * -el /y jai # I 1 ' 7 / i ) q 40 I - 1 ' p i 1 1 i 4 d, ,'ta,J U / i., ht,. 4:-"v 4 - a/ri t( ,-..', • i ' ,, , , p a_ ‘..- .0. Permit # Account Description A • Amt. Pd. Bal. Due Bldg. Permit (BUILD) 40 f- Plu� Permit (PLUMB) ech. Permit (MECH) c de -e- °�� ' C _ 4;1 FGC. State Tax (TAX) ,,// Bldg: /3 /v. 5L 1 7 / . 5 Plumb: Mech: ,/ • E (.0 a,od Plan Chec (PLANCK) 83.53 - Bldg: off'3 Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF -R) Mass Transit TIF (TIF -MT) Commercial TIF (TIF -C) Industrial TIF (T1F -1) Institutional TIF (TIF -IS) Office TIF (TIF -O) — Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) 11 .92/F‘. TOTALS: 3T2:, �!id p • CITY OF TIGARD BUILDING INSPECTION DIVISION ® 76 60. 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 G/� (/ BUP Date Reque ted 10/� � AM PM /6k 7 U n BLD . Location / Ill / 4 kD'\_,suite 0 %Y — 00C - 70 Contact Person T Ph -- PLM Contractor Ph SWR = UILDIN.V :, :, ' a Tenant/Owner ELC =e airzing Wall ELR Footing 250 N a L 1o^ / rein-ad Foundation Access: � � 1 FPS Ftg Drain SGN Crawl Drain Insper" - f 3 ="� r_ Slab !Not 'Requested SIT Post & Beam Found During Ree 4 Ext Sheath /Shear No nec .'on(sl in_File Int Sheath /Shear ` Framing �M I () L � - 767 .. Insulation `� /� Drywall Nailing 9 r L v .c I Fire wall i) S\-, ` - (y j 5 — \ l 0 � � w" Fire Sprinkler CA- Fire Alarm ) C-,NL- v\v` ��T Susp'd Ceiling Roof e,: - i C I i .. Mi — - — -� PART FAIL BING Post & Under Slab (LC.,°), U O 5,--- 0 — Top Out Water Service I S 1 �ye h,� �-, Nt ��-- Sanitary Sewer - _ ( n Rain Drains ��Vv \ '`'� . Final PASS PART FAIL CHANiCA N G r , INA vs S ..-\ ■ ` v- Post &Beam -- 3 ` • Rough In . 4 �� ■:^-C Gas Line Smok; Dampers 5r-- -e, C_ anal �. �— PART FAIL - TRICAL Service r Rough In / Co D 1-�� I • UG/Slab Low Voltage ( Fire Alarm I&I Final PASS PART FAIL . --7 SITE 11111.11 A;W Backfill /Grading ' VOW\ ‘ Sanitary Sewer Storm Drain Ii) ] Reinspection fee \o $ 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 c • Other Approach /Sidewalk 1 V �" 1 ) Date In Y lJ` Ext / Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.