Permit CITY OF TIGARD
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�,,, .„,„,,�,, DEVELOPMENT SERVICES
:�!l+l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
MASTER PERMIT
PERMIT # • MST96 -0468
0 410 DATE ISSUED: 10/08/96
P/ PARCEL: a:S 11 OCD -0330 z'
SITE ADDRESS...: 15775 SW ROYALTY PKWY
SUBDIVISION • ® ZONING:
BLOCK • LOT •
Remarks: TEARIFF ROOF, RE -SHEET AND RE -ROOF WITH 30YR ARCH. SHINGLES
BUILDING - --
REISSUE: A fg,STORIES • 0 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS — REQUIRED---- -
CLASS OF WORK.• HEIGHT • 0 FIRST • 0 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT : 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL -: 0 sf VALUE..$: 0 REAR • 0
PLUMBING — ------ ______
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN (100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS : 0 CLOTHES DRYERS: 0
FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES : 0 SAS OUTLETS...: 0
-- ELECTRICAL -
-- RESIDENTIAL UNIT— — SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS -- -- MISCELLANEOUS -- - -ADD'L INSPECTIONS -
1m SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 4w, amp..: 0 201 - 400 amp..: 0 1st W/0 5VC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1000 amp.: 0 601+amps 1'M v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 - - - -- PLAN REVIEW SECTION —
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR >=225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
— -- - - -- ELECTRICAL - RESTRICTED ENERGY — - - - - -- -- — —
A. SF RESIDENTIAL - B. COMMERCIAL - — -
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: .. BOILER • HVAC LANDSCAPE /IRRI6: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: ..
HVAC DATA /TELE COMM.: NURSE CALLS TOTAL H1 SYSTEMS: 0
Owner: -------------- - ---- --Contractor: TOTAL FEES:$ 71.93
C SAUB INTERSTATE ROOFING
15775 SW ROYALTY PKWY 15065 S.W. 74TH AVENUE
KING CITY OR 97224 TIGARD OR 97223
Phone B: Phone 0: 684 -5611
Reg B..: 55485
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 ---- -- - --- --- ---
Post /Beam Struct Rain drain Insp
Framing Insp Ponding before t
Shear Wall Insp Dry -rot after to
Insulation Insp Building Final
Gyp Board Insp Erosion Control , Q —(�
Pe Signature: micki� �) ` Issued B �( ]
Call for inspection — 639 -4175
SEP -25 - '9 WED 23: ID: FAX N0: 143 7 P02 .,._.. ,
�� / /O 6
33V /T
CITY/OF YIGARD Residential Building Permit Application Plan s ib
13125 SW HALL BLVD. • New Construction Additions or Alterations Date Reed 0
TIGARD, OR 97223 Single Family Detached or Attached Date to P.E.
(503) 639 -4171 Date to DST
Print or Type Permit ft L '6-12K
Called
. Inpomplete or illegible applications will not be accepted
Nartte of Subdivision Lot 0 Name
Job /Na- Cr t v Architect Mailing Address
Address Site Address
• /5'77s S Ieay 1 f Piel , City/State zip Phone
—_~ Name
• Owner Mailing Address Name
/ S 7 7 S'" S w / yt2€ - r /
Ci�!State Zip Phone En Mailing Address -
•
i � S r 4I y 472 29 - ..�'� -9 yam City /State Zip Phone
Name /
General 7 e Pirc /e 409, 9 GM.t Describe work new 0 addition 0 alteration O repair 0
1 Contractor Mailing Address to be done:
/5 s 3a 7 y4- '' Additional Oescriptien of Work:
i to I , E
Ci lState Zip — Phone / PQ v 0 tOAf re jAel Y . At
'gar:.,`: ''4 P e, .f 97LZ5/ (o1y. - SG //
Oregon Const. Cont. Board Lust x .Dat /".L' i'aUf zi4 h �G Axe H Sk /n/G /E}
Attach Copy or sS 3 e ' - 97 Project
Current COT Business Tax or Metro # Exp. Date Valuation T 7s9 _
Licenses 0O00/q74 MAR % •/17 NEW CONSTRUCTION ONLY:
Name .
Mec al Sq.Ft. House: Sq.Ft.Garage:
Sub- Mailing Address .
Contractor Corner Lot Yes ' No Flag Lot Yes No
city /state 4 . I Phone (check one) (check one)
Restricted Audio /Stereo Burglar
Oregon Const. Cont. Board Vest Exp. Data Energy System Alarm
Attach Copy of
.Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC
Licenses Opene Systems
Name (check all that Other:
I + Plumbing apply)
1 Sub- Mailing Address • Will the electrical subcontractor wire for all Yes ' No
Contractor restricted energy installations?
• City/State Zip Phone Has the Subdivision Plat recorded? N/A Yes . No
•
Oregon Con :t. Cont. Board t.ic.a Excl. Date Reissue of MST# Solar Compliance
Attach Copy of (Calculation Attached)
Current Plumbing Lie.* * Exp. pate I hereby acknowledge that I have read this application, that the
Licenses information given is correct, that I am the owner or authorized agent of
COT Business Tax or Metro # Exp. Date the owner, and tnat plans Submitted are In compliance with Oregon
State laws.
Name i re gn e10 n Ag nt Date
Electrical v S , 9 G. - 9� '
g i ij / n Sub- Mailing Address Ph r t / 3• //
Contractor FFOR FICE USE ONLY:
City /State Zip Phone Plat # Map/TL#:
Oregon Const. Cont. Board Lic•# Exp, Date
Attach Copy of Setbacks Zone: . Solar. -
Current Electrical Lie. # Exp. Date
Licenses
COT Business Tax or Metro # Exp. Date Engineering Approval: ' Planning Approval: TIF:
osts\mstapp.doc
1 .SEP -25 - ' 96 WED 23: 02 . • ,I D: FAX N0: i#327 P03
Permit # Account Desceptiorl
Amount Amt. Pd, Bal. Due
MST. Permit (BUILD) Cd3, Sa .
Plumb. permit • (PLUMB) •
Mech. Permit (MECH)
ELC /ELR Permit • (ELPRMT)
State Tax (TAX) S. 93 4 /3
Bldg:
Plumb:
Mech:
ELC /ELR:
Plan Check
• MST: (BUPPLN)
Plumb: (PLMPLN) •
Mech: (MECPLN) •
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge • • (PKSDC)
Residential TIF (TIF -R)
• Mass Transit TIF (TIF -MT)
Water Quality • (WQUAL)
Water. Quantity (WQUANT)
. Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
• Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
• TOTALS: 7i q3 71..
i :ldsts4nseapp.doc
Rev. 7/96