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Permit A CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICES PERMIT # : MST97 -0281 'liI DATE ISSUED: 07/11/97 :: -- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 SITE ADDRESS...:1558O SW ROYALTY PKWY � p' PARCEL: 2S110CD -01400 SUBDIVISION • FOIING: BLOCK LOT • JURISDICTION: KIN Remarks: Remove sheathing, siding covering original garage; add garage door; install AB panel at one wing; pour new driveway -- BUILDING REISSUE: STORIES • 0 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED - CLASS OF WORK.:ALT HEIGHT • 0 FIRST • 0 sf GARAGE • 300 sf LEFT • 0 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD • 1 SECOND...: 0 sf FRONT : 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT • 0 OCCUPANCY GRP.:R3 BEM: 0 BATH: 0 TOTAL 0 sf VALUE..$: 0 REAR • 0 - - -- PLUMBING SINKS : 0 WATER CLOLSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 — MECHANICAL FUEL TYPES FURN ( 1w4K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0 FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 0 — ELECTRICAL ---- - RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — ---- MISCELLANEOUS— — ADD'L INSPECTIONS - 1m SF OR LESS: 0 0 - 200 alp..: 0 0 - 200 alp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 alp..: 0 201 - 400 alp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR • 0 LIMITED ENERGY.: 0 401 - alp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0 MANF HM /SVC /FDR: 0 601 - 1m amp.: 0 601 +amps -1 '.'. v: 0 MINOR LABEL -10: 0 1000+ amp /volt.: 0 - PLAN REVIEW SECTION Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC: — ------------ ELECTRICAL - RESTRICTED ENERGY ----- -- A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: .. BOILER • HVRC • LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: •. HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL # SYSTEMS: 0 Owner: — - Contractor: TOTAL FEES:$ 42.50 BEVERLY FROUD BROOKSIDE ENTERPRISES This permit is subject to the regulations contained in the 12200 SW BULL MOUNTAIN RD WALDEN L COLE Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD OR 97223 8945 SW CRESTWOOD ST other applicable laws. All work will be done in accordance PORTLAND OR 97223 with approved plans. This permit will expire if work is Phone #: 639 -2539 Phone #: 245 -6723 not started within 180 days of issuance, or if the work is Reg 8..: 0055591 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 OJNC by calling (503)246 -1987. - -------------------------------- - REQUIRED INSPECTIONS - Framing Insp Shear Wall Insp Rain drain Insp Building Final Issued By: CSC Permittee Signatu.:re ,q/L &e2 SO + + + + + + + + + + ++ +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ + „..e. Call 639 -41 5 by 6:00 p.m. f or an inspection needed the next business day @ Plan Ch ! -2 3i OF T I G ARD Residential Building Permit Application Recd By `?25 SW HALL BLVD. New Construction Additions or Alterations Date Recd I- t---eh 'ARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. • 503- 839 -4171 � \ � Date to DST :03 -684-7297 5 Permit # /✓� 5 1 — q7 - 6a87 a Print or Type 7 �� Called Incomplete or illegible applications will not be accepted - Name of Project . _ -_ - - - _ Name Job .i , . /. /it Address - site Address . __ � •��- - - -• - Architect Mailing Address AI I h r.. lam\ ei� : Nam .Q / City /State • -- • - -- • Zip \I d 9 !.t lA l.► 17 / e I Phone Owner Mailing Address / Name A-2 a © 4 9.0) !.! ali l i )&177 ed) AI Mailing City/ fa te Zip Phone Engmeer g Address (/,., -J. flY C 7210 6O��CI - A.12`1 City/State Zip . Phone N / General /e'!l!/l.r✓51ai-: y / � , p� , ,...„.1 Describe Desbe work New 0 Addition 0 Alteration Repair 0 Ontractor Marling Address � � / to be done: • Y �'�1 ✓ X16 C .C� f��i� h S7 . - Addition?! of Work: , f e�c_.`� ►. /, e6 ,9, • to Zip Phone - U)etJ I9-q/aV 6 D2 7 �?du2 ivcr�J ,9 .e%. A,-.n� y . 7zz-3 ...1-v--;4 , '�2��'veul Oregon Const Cont. tic.* Ex to teach Copy of / 6 ' ES ma . Current COT Business Tax or Metro Oa PRO ���� - Licenses - not 4 - - - VALUATION $ _ % • Name - echanical -- - - _. _ __- __... _- ___- .,- .- ._____ '' NEW CON CTION ONLY: Sub- Mailing Address Sq. Ft. House: Sq. Ft. Garage Contractor _ . _ , Corner Lot YES NO Flag Lot YES NO City /State Zip Phone (check one) (check one) . . - Oregon Con Cont. Board Lic# Exp. Date Restricted Audio/Stereo Burglar Conn. Attach Copy of -- Energy 'System -- . - - Alarm Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC Licenses Name _ Opener Systems Plumbing ( check all that Other: 9 pply) . 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 Const Cont. Board Licit Exp. Date Reissue of MST* Solar Compliance Attach Copy of (Calculation Attached) - LCicensest Plumping Lie * Exp. Date I hearty acknowledge that I have read this application, that the COT Business Tax or Metro* Exp. Date information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance Name with Oregon State laws. ;lectrical ` Sign r- • f 0 -r/Age t Date Sub- Marling Address ' �4 ..� � � �' hd O i �ntractor CO / .. 1 Ph e City/State Zip Phone • ICE USE ON Y: Plat #: ' Map/TL#: Oregon Cons. Corn. Board Uc.# Exp. Date . ach Copy of Setbacks: Zone: Solar. Current Eierncal l.ic. # Exp. Date Licenses Engineering Approval: Planning ; COT Business Tax cr Metro * Exp. Date g g pp 9 pproval: TIF: =REMDLDOC (DST) 3197 rermu W Acct. uescntpion GUI WAGO Amount Amt. Pd. Bal. Due +i . MST. Permit (BUILD) (UBUFLDi 2. Plumb. Permit (PLUMB) (UPLUMB) Mech. Permit (MECH) (UMECH) ELC/ELR Permit = (ELPRMT) -- (UELPMT) - State Tax - - - (TAX) ' . (UTAX) ... 2 . - - - _ BLDG: - - - — PLUMB: —' MECH: - - - ELC/ELR: -- Plan Chec . _ . ._ _ ,; -- - e op BUPPLN U , 2 r J . Plumb: (PLUMB) (UPLUMB) . . _. _ Mech: - . _ - (MECPLN) ---( UMEPLN) - - - - -- -- - - -------- .--- _• - - - - - -- - - - CDC Review (BUILD) (CDCBLD) • ' (UCDC) CDC Review (PLN) -A - C (CDCPLN) / N/A . . _ ;zp Sewer Connon (SUSA) � W (USWUSA) Reimbur. District ( .. -- - . ) -- (--_ - ) - _ - Sewer Inspection n:1 r. (SWINSP) (USWINS) Parks Dev Charge (PKSDC) N/A Residential TIF - -- (TIF- R) - - -- - (UTIF -R) _____ ... _ ._ . - .' - Mass Transit TlF (TIF -MT) -: _ (UTIF -M) _ . __ .._ _ . • Water Quality (WQUAL) . (UWQUAL) - - - -- - - Water Quantity - - - ( WQUANT) (UWQANT) - • Erosion Control Prmt (ERPRMT) (UERPMT) Erosion Planck/USA (ERPLN) (UERPLN) Erosion Planck/COT (EROSN) (UEROSN) Fire Life Safety -- (FLS) - (UFLS) TOTALS: �y I:SFREMDLDOC (DST) 6/97 . < 6 :6) j _ _ • KING CITY 15300 S.W. 116th Avenue, King City, Oregon 97224 -2693 Phone: (503) 639 -4082 • FAX (503) 639 -3771 Notice To Contractors Working In King City Due to an intergovernmental agreement with the City of Tigard, many building related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be returned to King City staff for correction and no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff will simply sign this form indicating land use approval. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are available at 639 -4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: , - a a- ..Gj j lL--- located at: A5 ..5 w /Q-0-1 �l a Nag, King City Representat I:\DSTSU:CINST.DOC recd 7- fo&J OVER- THE - COUNTER (OTC) PLAN REVIEW COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST DESCRIPTION OF PROJECT: f 'i 4 9 d ,, f) p / V P). ) 77 � CA - A/1Y r Ve. ) (s�� � nos �iA f ,'/ � 6 94-71? 1 4 T r21 7liv t r j ' i f4 /( l' ,4 -)^ ..( D ' V )--- CLASS OF WORK: A 1- /- FLOOR AREAS: EXTERIOR WALL CONSTRUCTION TYPE OF USE: S'/ FIRST — SQ. FT. N: S: TYPE OF I CONSTR: 1/ /`/ SECOND SQ. FT_ i PROTECT OPENINGS ?: I I OCCUPANCY GRP: THIRD SQ. FT. N: S: OCCUPANCY LOAD: I – Aitni,7 I TOTAL SQ. FT. I ROOF CONSTR: FIRE RET: STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RATED: BSMNT?: MEZZ ?: GARAGE: 7(96 SQ. FT. OCCU.SEP.RATED: FIRE FIRE SMOKE HANDICAP SPRINKLER: ALARM: DETECTOR: ACCESS: FOOT/FOUND INSULATION SUSPENDED CEILING SMOKE DETECTOR INSPECTION INSPECTION CEILING INSPECTION POST /BEAM SHEAR WALL / SPRINKLER APPROACH /SIDEWALK INSPECTION INSPECTION Y ROUGH -IN INSPECTION MASONRY FIREWALL SPRINKLER MISCELLANEOUS INSPECTION INSPECTION FINAL INSPECTION FRAMING / GYP BOARD FIRE ALARM FINAL INSPECTION ✓ INSPECTION INSPECTION INSPECTION ::....::....::.:... ..: ::::. COM °;... c mme cra ... S... .:coir�iercla[: >r:'►al;iufact�l . ed. stnictuie':> �:><°:::>::> ?::<:>::> `��< <�::' »: >. >: <: >: <<': >:: >< >': > 'CLASS_::COF:::WORK R:AL L: PERMITS :::NEW:- -= nev)r;A :; = >:addt ALT:;= alteration. ACS<:= ':aces '::FNb ;:: >:: := founded <'OTR = otl'ier, QEM: >= demolition- REP; > =: <ie FPS.:. = :rice:: rotection >:.FENCES : RETAINING WALLS :.DETACHED DECKS;SIGNS::AWNINGS:> i: bvrcntr3.doc (DST) 4/97 1 • 6/6/00 • Activities for Case #: MST97 -00281 • 2:40:16 PM • Assigned Hold Updated � '4, Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA005 Application received 7/7/97 BON RECD CTR 7/11/97 • MSTA008 Permit Created • 7/11/97 JDA PASS CTR 7/11/97 MSTA010 Check for prcl. restrict. 7/7/97 - BON PASS CTR 7/11/97 • MSTA012 Plans routed to Plans Examiner 7/7/97 BON PASS CTR 7/11/97 OTC MSTA026 Plans approved by Pln Examiner 7/7/97 •JDA PASS CTR 7/11/97 MSTA030 Reviewed plans routed to DSTS 7/7/97 JDA PASS CTR 7/11/97 MSTA032 DST Post - Review Completed 7/7/97 JDA PASS CTR 7/11/97 • • MSTA725 Framing Ins') • 7/23/97 RB PASS J'H 7/23/97 Arrived, found key for garage, house locked, called for post and beam, found permit, • • - inspected garage header and • • shear wing wall inspected. - MSTA726 Shear Wall lnsp CTR 7/11/97 MSTA799 Building Final CTR 7/11/97 • MSTA755 Rain drain lnsp 7/11/97 CTR 7/11/97 • MSTA092 (F) Issue combination permit 7/11/97 JDA PASS CTR 7/11/97 MSTA945 Request inspection research 5/22/00 ST • DONE No Hold ST 5/22/00 • MSTA153 Expired by limitation 6/5/00 HAP DONE No Hold AKJ 6/5/00 • • • • • Page 1 of 1 • •