Permit A CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00454
, DEVELOPMENT SERVICES DATE ISSUED: 9/29/00 •
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 08516 SW LUCILLE CT PARCEL: 1S135AD -04400
SUBDIVISION: LUCILLE ESTATES ZONING: R -12
BLOCK: LOT: 006 JURISDICTION: TIG
REMARKS: Fire repair - truss details need to be available at framing inspection.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: REP HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 51,398.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 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: BOIL/CMP < 3HP: VENT FANS: 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 FOR: 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: $ 1,244.83
This permit is subject to the regulations contained in the
NATHAN, ERWIN J OREGON HOME IMPROVEMENT CO
8516 SW LUCILLE CT DBA OHI CONSTRUCTION Tigard Municipal Code, State of OR. Specialty Codes and
TIGARD, OR 97223 • 17255 SW PILKINGTON RD all other applicable laws. All work will be done in
LAKE OSWEGO, OR 97035 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 a re set
Reg #: LIC 00034908 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 Insp Electrical Final
Plumb Top Out Mechanical Final
Electrical Rough In Plumb Final
Framing Insp Final inspection
Insulation Insp
7
Issue By : _- / / Id -fil _2....l.- Permittee Signature : ..��� / '_�1
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed th • next bu mess day
IF OF TIGARD • Residential Building Permit Application Plan C. -
13125 SW HALL BLVD. Alteration - Interior Only Recd e
Wit
Family y or � p �
TIGARD, OR 97223 Single Fil Detached Attached (Duplex) Date Rec
Date to P.E. 2
V 503 - 639 -4171 Date to DST - 89 -cid
F 503 -684 -7297 Permit # N511e n -ao ys1
•
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Project Name
Job
Address Site Address c \ 1_ (( Architect Mailing Address
F 1(4 �.7�Z iu�lr U City/State Zip Phone
Nate ,,, i
J J;c___t< 1 pttv1Rw.i Name .
Owner Mailing Address /
/n S� ' parr / e - 3 l r f I -- Engineer Mailing Address
1 State Zip Phone
C421 M.22,.& U I3 — �.1 -7 S City/State Zip Phone
General N,
Contractor l3 .. \ $- Describe work New 0 Addition 0 Alteration 0 Repair
Milling Address to be done:
Prior to permit 7 Sc, t Lk; vA-6" Additional
of all licenses (� Cat 1' ? O 3 � ,616-2..f4 � P 1
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Li c.# 214 , B VALUATION $SEaf:3r,-..
database //J
Mechanical Name " " �� � NEW CONSTRUCTION ONLY:
Sub-
k
Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Indicate the restricted energy installation by the electrical
issuance, a copy City /State ip 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- SC•Tn p apply)
Contractor Mailing Address � y �� Corner Lot YES NO Flag Lot YES NO
? � (check one) (check one)
,IJC� Ha s the Subdivision Plat recorded? N/A YES NO
Prior to permit ity /State Zip Phone
issuance, a copy I Q, Cfat 914§ , 9e 0 ' 0(6' C: 7 6 1 diar Compliance
of all licenses are Oregon Const. Cont. Board "Exp. Date (Calculation Attached)
required if Lic.#
expired I hearby acknowledge that I have read this application, that the
database is COT
Pll oZb �l /0 00 �(7tJ
d a t umbing Lic. # Ex Date information given is correct, that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
37 —/7 / 4 IS 6 V C) / Oregon State laws.
Name 1 J_S�' r of Owner /A t Date
Electrical \I 1da,i+e ' a'_ J' v 'a_ /6-29
Sub- Mailing Address ` ntact erson Name P one #
Contractor 31(nS �h ;RS- S Ii IN C . FOR OFFICE USE ONLY: i
City /State Zip Phone Plat #: Map/TL #:
Prior to permit /t J Ot
issuance, a copy �'�t00. Slott. . gcs? I Z
Setbacks: Zone: Solar:
of all licenses are Oregon onst. C nt. oard Exp. Date
required if Lic.#
. expired in COT /O /9 /D 0 Engineering Approval: Planning Approval: TIF:
database Ele ical Lic. # Ex D to
L (' 3 0 q - C. /t o / O t. t
Ele n ery
cal Supervisor ic. # x a t e
t iiIn0 S ; ! /Ot
i:forms\sfintalt.doc (DST) 10/23/98
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
-
IMPORTANT PERMIT NOTICE •
VANDER STOEP ELECTRIC
23765 THIRD ST NE
AURORA, OR 97002
Electrical Signature Form
Permit #: MST2000 -00454
Date Issued: 9/29/00
Parcel: 1 S135AD -04400
Site Address: 08516 SW LUCILLE CT
Subdivision: LUCILLE ESTATES
Block: Lot: 006 •
Jurisdiction: TIG
Zoning: R -12
Remarks: Fire repair - truss details need to be available at framing inspection.
•
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
NATHAN, ERWIN J VANDER STOEP ELECTRIC
8516 SW LUCILLE CT 23765. THIRD ST NE
TIGARD, OR 97223 AURORA, OR 97002
Phone #: Phone #:
Reg #: LIc 69417
SUP 4360S
ELE 24 -304C
AN INK SIGNATURE IS REQUIRED O THIS FORM
X /4-01
S' nature of Supervising Electrician
•
If you have any questions, please call (503) 639 -4171, ext. # 310
•
•
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
NELSON PLUMBING
PO BOX 818
BATTLE GROUND, WA 98604
Plumbing Signature Form
Permit #: MST2000 -00454
Date Issued: 9/29/00
Parcel: 1 S135AD -04400
•
Site Address: 08516 SW LUCILLE CT
Subdivision: LUCILLE ESTATES
Block: Lot:. 006
Jurisdiction: TIG
Zoning: R -12
Remarks: Fire repair - truss details need to be available at framing inspection.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received •
OWNER: PLUMBING CONTRACTOR:
NATHAN, ERWIN J NELSON PLUMBING
8516 SW LUCILLE CT PO BOX 818
TIGARD, OR 97223 BATTLE GROUND, WA 98604
•
Phone #: Phone #:
Reg #: LIC 125759
PLM 37 -171 PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X / (i 2,*WARA Zi&
Signature of Authorized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD BUILDING INSPECTION DIVISION 2.e/el/ a6
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP -
Date Requested 0- Z- 2— AM PM BLD
Location g5 to $ w Lk 0/. %l. Suite MEC
Contact Person (e.ert7 Ph 6 PLM
Contractor Ph SWR
UILD Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain t � � Z �C , f-v 6 G
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall on 1 ^ ` n�
Drywall Nailing �/�/�'J
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mi
t y'T
PART FAIL
P • BING
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
Service
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
U -
Ext
Other Date 1 1 Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.