Permit , A CITY OF TIGARD
,\ DEVELOPMENT SERVICES MASTER PERMIT
i_ 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE I ISSUED: 04 / `2 /98 117 2/98
PARCEL: 1S135CD -09700
SITE ADDRESS...:09979 SW PIHAS CT
SUBDIVISION -JACOB COURT ZONING: R -12
BLOCK LOT •005 JURISDICTION: TIG
Remarks: Single family detached, Path 1.
BUILDING
REISSUE: STORIES : 2 FLOOR AREAS — BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED —
CLASS OF WORK.:NEW HEIGHT • 23 FIRST • 553 sf GARAGE • 395 sf LEFT • 7 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 885 sf FRONT • 20 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: 1 FINB5MENT: 0 sf RIGHT • 17
OCCUPANCY GRP.:R3 BDRM: 4 BATH: 2 TOTAL : 1438 sf VALUE..$: 103186 REAR • 15
PLUMBING
SINKS . 1 WATER CLOSETS.: 2 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 1w TRAPS • 0
LAVATORIES • 2 DISHWASERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 1' SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS... : 2 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 1'." BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN (100K ..: 1 BOIL /CMP ( 3HP: 0 VENT FANS • 3 CLOTHES DRYERS: 1
6AS FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 1 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 1
ELECTRICAL
— RESIDENTIAL UNIT— -- -SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — — MISCELLANEA— — ADD'L INSPECTIONS -
1'.z SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 2 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 681 - 1m amp.: 0 601 +amps- 1 v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 — PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC BCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL -
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: X BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: ..
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL 0 SYSTEMS: 0
Owner: Contractor: — TOTAL FEES:$ 4706.11
CHAD E DAVIS CHAD DAVIS This permit is subject to the regulations contained in the
PD BOX 794 PO BOX 794 • Tigard Municipal Code, State of Ore. Specialty Codes and all
FOREST GROVE OR 97116 FOREST GROVE OR 97116 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: 693-6580 Phone 0: 693 -6580 not started within 180 days of issuance, or if the work is
Reg 0..: 000825 suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952-001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
REQUIRED IPCTIONS
Erosion 844 -8444 Crawl Drain /Back Electrical Rough Gas Line Insp Water Line Insp Plumb Final
Footing Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp
Post /Beam Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post /Beam Meehan :ccttr Servi Fireplace Insp Rain drain Insp Mechanical F
Issued By: �� �t / / � Permittee Signature: �
++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++ + + + + + + + + + + ++
Call 639 -4175 by :00 p.m. for an inspection needed the next business day
CITY OF TIGARD Residential Building Permit Application Plan check #i -z Rec'd By 13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd ,j. ;, 4 .
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. VFW:
V 503- 639 -4171 Date to DST `
F 503 -684 -7297 Permit # 3T - /
Print or Type Called - Ll - g
Incomplete or illegible applications will not be accepted got 91 - a070
Name of Project Name
Job 7cACah c).-. Les+ 5 • / $ t
Address Site Addre s / Architect Mailing Address
9 4 - w i�t,. nito C . 0/170 sW Cove ee b e. 1- Z 4 0
NarAQ t4' /Sta c�A 0g. clue/ r '1q Phone
Zo 7Z
Cl �.v, 5
Owner Mang Address Nam
.0, 79�/ 7i1 COV cr.\-
City/State Zip Phone Engineer Mailing Address
+res Grove- OR. g9 t14 I 6,,q3-1,, sec)
General Name City/State Zip I Phone
Contractor C1-k At E. - 1 . 01/4vAS Describe work New4 Addition 0 Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit , 0 . Solt 1 Additional Description of Work:
issuance, a copy City /State Zip Phone
of all licenses covv,S+ Co rwe, CP , 9 t i I I (04 - 6586
are required if ' Oregon Const. Cont. Board Exp. Date PROJECT I ,
expired in COT Lic.# ?25 12 5 A / /98' VALUATION $ Sir 500 °
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- Ye\krS irl (.c.."A9■ Ct Sq. Ft. House: Sq. Ft. Garage
Contractor ^filing Address J I y 3g 39 5--
Prior to permit KO 3a A S/ 7 Corner Lot YES N Flag Lot YES
I
issuance, a copy City/State Zip Phone (check one) (check one)
of all licenses Foresk (,cove. 91 WI) 357 -4'n95 Restricted Audio /Stereo ' Burglar
are required if Oregon Const. Cont. Board Exp. Date Ener
expired in COT Lic.# 1 0 u 2 ��o g4' System Alarm
database 24/79 Installation x Garage Door HVAC
Plumbing Name Opener Systems
Sub- Yeti WAS CoNST 'INC . (check all that Other.
apply)
Contractor 'Mailing Address '
P.
o LAX 23o9 25 Will the electrical subcontractor wire for all 1(E$ NO
Prior to permit City/State Zip Phone restricted energy installations? x
issuance, a copy -71(00,r,4 a. Glyn/ D /' 4'4'31 Has the Subdivision Plat recorded? N/A SZ NO
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# /0 Compliance
expired in COT to (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
3q- 232 e 3 information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
Electrical ` with Orego tate laws.
U It 1 '1.., A.:. V ign 1 C,f S of O Age �/
Sub- cling A ddress �J 2� a /�
Contractor r 1 N a e
City/State � 5 � z � � 1� E . T A) \S 358 - 8�3y
Zip Phone Co ct Pers
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy ■r ` 9 rim C as_ 71 l_, 3 Plat #: Map/TL#:
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# / n 6 LI �l dL 16/35-e-0 -1-e-005- -1-e-005- expired in COT (D / Setba s: n �� ` Zone: n _, Solar.
database Electrical Lic. # Exp. Date K
2 119 S gl g Approval: Planning Approval: TIF:
t i i ii p,,u1 6).
W / 2c_ts I:SFREM.DOC (DST) 4/97
All
CITY OF T
OREG
INTENT TO HAUL EXCAVATION
1, ( ' ,N AZ E . Won (print name), hereby certify that all excavation
material on the subject property will be removed from the site and not be placed as fill,
except for that amount necessary to back -fill the foundation ONLY. I understand that
failure to remove the excavation material will result in the requirement to remove the
material or obtain a grading permit by submitting grading plans prepared by a licensed
engineer accompanied by a geo- technical report regarding the placement of the
excavation material as fill.
/ - ,/- • 3/3//g
•
Signature Date
Q97 9'
Job Address: 61 S (A) P
Subdivision: Sote_ob C-4- I . Lot: _____5
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
I:haul.doc (DST) 6/97
6/4/99 Activities for Case #: MST98 -00117
9:42:22 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA005 Application received 4/9/98 JSD RECD DRA 4/14/98
MSTA008 Permit Created 4/14/98 DEB DONE DRA 4/14/98
MSTA010 Check for prcl. restrict. 4/14/98 DEB DONE DRA 4/14/98 Site plans needed to be
revised. Spoke with Chad
Davis on this date and he is to
revise and bring in 5 new plans.
App /plans are to the left of my
computer.
MSTA012 Plans routed to Plans Examiner 4/14/98 DEB SENT BON 4/21/98
MSTA026 Plans approved by Pln Examiner 4/20/98 RT PASS BON 4/21/98
MSTA030 Reviewed plans routed to DSTS 4/20/98 ' RT PASS BON 4/21/98
MSTA032 DST Post - Review Completed 4/21/98 B DONE BON 4/21/98
MSTA700 Erosion 844 -8444 DRA 4/14/98
MSTA705 Footing lnsp 5/7/98 WDJ FAIL WDJ 5/7/98 not ready
MSTA706 Foundation lnsp 5/12/98 KS PASS J *H 5/13/98 Noted Approved: #1 Monolithic,
f.t.g. f.dn. #2 Ufer rod tag. #3
Locate f.d.n. vent within three
feet of comer of structure #4
Install low point drain (sleeve)
MSTA710 Post/Beam Structural 5/15/98 WDJ • FAIL WDJ 5/15/98 1. Provide anchor bolts in
mudsill within 12" of ends
where notched over 50% for
plumbing. 2. Provide min. 1/2"
aer gap at all beam pockets. 3.
Remove form from
footing.—Done during inspection
4. Pass plumbing inspection
MSTA711 Post/Beam Mechanical 5/15/98 WDJ PASS WDJ 5/15/98 furnace can to be insulated at a •
later date.
MSTA713 Crawl Drain /Backwater valve 5/15/98 RB FAIL RB 5/15/98 low point drain not installed no
back -water valve installed
MSTA717 PLM /Underfloor 5/15/98 RB FAIL RB 5/15/98 crawl drain failed no test on
water sewer= ok rain drain = ok
protect ABS Sanitary and vent
lines in contact w/ concrete
• protect water and ABS lines at
. plate seal footing where
plumbing penetrates
MSTA720 Mechanical Insp 6/22/98 WDJ PASS WDJ 6/22/98
MSTA722 Plumb Top Out . 6/18/98 MS PASS J'H 6/23/98
MSTA723 Electrical Service DRA 4/14/98
MSTA724 Electrical Rough In DRA 4/14/98
Page 1 of 3
6/4/99 Activities for Case #: MST98 -00117
9:42:22 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA725 Framing lnsp 6/22/98 WDJ FAIL WDJ 6/22/98 1. Strap top plates in upstairs
. closet that do not overlap. - can
check at insulation inspection.
2. Provide copy of plumbing
top out approval.
MSTA726 Shear Wall Insp DRA 4/14/98
MSTA728 Low Voltage DRA 4/14/98
MSTA735 Gas Line lnsp 6/22/98 WDJ PASS WDJ 6/22/98 tag #323104
MSTA740 Insulation Insp 6/23/98 WDJ PASS WDJ 6/23/98
MSTA745 Gyp Board Insp DRA 4/14/98
MSTA761 Water Service Insp 5/15/98 RB FAIL RB 5/15/98 no test !
MSTA765 Appr /Sdwlk lnsp 9/4/98 MW PASS J'H 9/8/98 2nd try same day, okay to pour
following: 1. rain drain pipe
installed. 2. need 6 -inch
concrete in approach area. 3.
Remove & repour wing to west.
MSTA790 Electrical Final 9/22/98 BRP PASS B'P 9/23/98
MSTA795 Mechanical Final 10/15/98 KS FAIL J'H 10/19/98 See bldg final this date.
MSTA797 Plumb Final 9/21/98 DD PASS J'H 9/21/98
MSTA799 Building Final 10/15/98 KS FAIL J'H 10/19/98 1. Support b -vent at horizontal.
2. Provide latch at crawl access
door. 3. Back draft damper at
kitchen not closing. 4. Support
heat ducts at crawl. 5. Remove
wood forms at crawl. 6. Seal
joint between exterior siding
and birdblock at rear. 7. Need
final erosion control approved.
MSTA080 (F) Ready to issue 4/21/98 B MEMO GEO 4/22/98 All contractors need various
licensing updates to database.
• RECEIVED ALL
CONTRACTOR UPDATE ON
LIC. ON 4/22/98 GEO
MSTA092 (F) Issue combination permit 4/22/98 GEO PASS GEO 4/22/98
MSTA095 Issue plumbing signature form 5/1/98 JMT RECD JT 5/1/98
MSTA097 Issue electric signature form 4/22/98 GEO DONE GEO 4/22/98
MSTA752 Rain drain Insp 5/18/98 5/18/98 TLP PASS J'H 5/18/98
MSTA761 Water Service Insp 5/18/98 TLP PASS J'H 5/18/98
MSTA717 PLM /Underfloor .5/18/98 TLP PASS J *H 5/18/98
Page 2 of 3
6/4/99 Activities for Case #: MST98 -00117
9:42:22 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA710 Post/Beam Structural 5/22/98 5/20/98 KS PASS J *H 5/22/98 Approved as noted: Lower low
point drain level with grade.
Also need to dry pack or grout
around pipe at penetrating
footing.
MSTA727 Exterior Sheathing Insp 6/8/98 KS FAIL J'H 6/10/98 Plans on site not legible, water
damaged.
MSTA727 Exterior Sheathing Insp 6/11/98 KS PASS J'H 6/16/98
MSTA723 Electrical Service 6/22/98 CD PASS CD 6/22/98
MSTA724 Electrical Rough In 6/22/98 CD PASS CD 6/22/98
MSTA097 Issue electric signature form 6/23/98 JT MAIL JT 6/23/98 chuck dutton did an inspection
on 6/22/98 and noted no
electrical contractor was named
on this permit. but, geo printed
electrical signature form ? ??
Chuck verified that Rapid is the
contractor, so I added them to
"name" printed a signature form
and mailed it today. Jeanne T.
MSTA725 Framing Insp 6/23/98 WDJ PASS WDJ 6/23/98
MSTA795 Mechanical Final 10/22/98 KS PASS KBS 10/23/98
MSTA799 Building Final 10/22/98 KS PASS KBS 10/23/98
MSTA050 Hold for 11/19/98 JMT NOTE JT 5/10/99 holding c/o, see electrical sig.
form. e-mail to Chuck on
11/19/98 "have not received it"
5/10/99 SENT ANOTHER
MESSAGE TO CHUCK.
JEANNE
MSTA097 Issue electric signature form 6/4/99 JMT RECD No Hold JT 6/4/99
MSTA960 (F) Issue.Cert. of Occupancy 10/22/99 TIG KS DONE No Hold JT • 6/4/99
Page3of3
•
CITY OF TIGARD BUILDING INSPECTION DIVISION ,. 1 '
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 M �� �� /7
pfi /
:UP
Date Requested AM PM !. BLD
Loc Lion "C q7'T S2 () AAal ( Suite Z-10 MEC
Contact Person "O �
Ph , q�/ / Yo G PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
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 / /-4 [� dZa3'sc9 &tA- 7
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc
final
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS T FAIL
ECHANICAL
Rough In
Gas Line
S Joke Dam•ers
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
Other Date 2 -! t' Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.