Permit CITY OF TIGARD BUILDING PERMIT
P ERMIT #: BUP2000 -00213
i t DEVELOPMENT SERVICES DATE ISSUED: 06/21/2000 •
— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09740 SW RIVERWOOD LN PARCEL: 2S114BD -02100 _
SUBDIVISION: COPPER CREEK STAGE 2 ZONING: R -4.5 7 :
BLOCK: LOT: 038 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? - - - - -.
TYPE OF CONST: 5N . sf N: S: E: W: R ;
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED .
FLOOR LOAD: psf LEFT: 4 ft RGHT: ft FIR SPKL: SMOK DET: •
DWELLING UNITS: FRNT: ft REAR: 32 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 7,300.00,
Remarks: INSTALLING ROOF OVER DECK APPROX. 308 SQ FT.
Owner: Contractor:
SARKOWSKY, N LYNN RALPH GOMEZ
9740 SW RIVERWOOD LN 2080 SW MOSSY BRAE RD
TIGARD, OR 97224 WEST LINN, OR 97068 • --
Phone: Phone: ORIGINAL .
Reg #: LIC 65843
FEES REQUIRED INSPECTIONS .
' Type By Date Amount Receipt Footing Insp _______
PLCK BT2 06/06/200C $68.58 0002749 Post/Beam Insp __
Framing Insp
PRMT KJP 06/21/200C $105.50 0003167 Rain Drain Insp
5PCT KJP 06/21/200C $8.44 0003167 Final Inspection .
Total $182.52
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 =001 -1987. You
may obtain a copy of these rules or direct questions to NC by calling (503) 246 - 1987. _ .
Pe rm itee •
Signature: x 40 01111...-
,
Issued By: -
Call 639 -4175 by 7 p.m. for an inspection the next business day •
i /-
CITY OF TIGARD Re Building Permit Application Plan C ckf — C
13125 SW HALL BLVD. Additions or Alterations Recd y
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date Recd 49.. lo -
g y � p � Date to P.E. � �� �' �
V 503 - 639 -4171 Date to DST - 0 c
F 503 - 684 -7297 / GI l Perm Bit # Pa WO -- a 0 2/3
Print or Type Called Agt -PN- ✓- m09- b/Zd tio
Incomplete or illegible applications will not be accepted
Name of Project Name
Job k( VA c s
Address S ite Address � Architect Mailing Address
97 see) ) C/eZi.4)a2i LN City/State-- -
ityState Zip Phone
Name
ie-aa - 5 Name
Owner Mailing Address ,
9 7 1 7 1 0 S ) Hi V6fizefood iev Engineer Mailing Address
City/State G�Z P h one
� � _� / �2 �VI �(obr-72 /2 City/State ' Zip Phone
General NanTe
Contractor )ii -.,ph U _ Describe work New 0 Addition Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit b Sc. r) !Most f/ a p_ - Ad Additional De ription ofW ork: • //--
issuance, a copy City/State Zip Phone 'O '1 S/v / ,-c o t
of all licenses C1JZ S7Z- 1.cc....i 9 7pbcf 6038 -94 V
are required if Oregon Const. Cont. Board Exp. Date PROJECT � l% t - � c7c-)
expired in COT Lic.# r� n/ VALUATION $ ` ( 3 �
database �ei 4 ` 3 ' / /D/ V /
Mechanical Name NEW CONSTRUCTION ONLY:.3uS' [let /( /Z' 1
Sub- Sq. Ft. House: r Sq. Ft. Garage
Contractor Mailing Address
Indicate the restricted energy installation by the electrical
Prior to permit
issuance, a copy City /State Zip Phone subcontractor in the Poll wing areas
of all licenses Restricted Audio /Stereo
are required if Orego onst. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic. - Installations Vacuum Irrigation
database / System System
Plumbing Name (check all that Other:
Sub- 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
issuance, a copy
of all licenses are Oregon Const. 0 t. Board Exp. Date
required if Lic.# I hearby acknowledge that I have read this application, that the
expired in COT
database Plu ng 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 S Sig - , e of Owner /Agent O Date
Electrical �� -5---c.„,
ont- w' erson Na e — Phone #
Sub- Mailing Address - - ' 96717
Contractor
City/State Zip Phone
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. C nt. Board Exp. Date Plat #: Map/TL #:
required if Lic.# A5/ /(/ gb_ O a. /o o
expired in COT
database Electri ' Lic. # Exp. Date Setbacks: Zone: n _ . /, ,✓ Solar:
ectrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: Y TIF:
�� P U K
3 - i' Po.
�u PPS j�:. ( / D 5? is \dsts \formslsfaddalt.doc 11/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171.
/ BUP ` - C'xD ?J3
Date Requested (o7Z�j/ W AM PM BLD
Location q) IZI (, 'LI.t z)0 Suite MEC
Contact. Person k��tJfri Ph ./' ,c(n 2 PLM
Contractor Ph SWR
UILDIf Tenant/Owner ELC
Retainin • - ELR
- ootin, 12,E Access:
oundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: c d2 ����
Slab � SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Frgming ' .mo o Sr' ' &t S. / 4i? /4'4 rs
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
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 Date 2 ? �U Inspector Ext
r
Othe
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION • MST
24 -Hour Inspection Line: 639 -4175 • Business Line: / 639 -4171 1
Requested G�Q� '� AM 1C PM BUP 7,� 602 l 3
Date Re
4 ��'-/ BLD
Location - 1 L ID !2 v CA, (19Q Suite • MEC
. Contact Person Ph ZS ( — S(p PLM
Contractor Ph SWR
ObILDIO Tenant/Owner ELC
Retaining Wall ELR
ndation Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing & div6 ,QV4 / - - --5 GCCc i',E■7
Insulation
Drywall Nailing w44X--
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART OP
•
PLUMBING
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 V
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 Date : -— 2 2 — G� Ins Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.