Permit CITY OF TIGARD
DEVELOPMENT SERVICES MASTER PERMIT
� PERMIT # • MST97 -01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 04/28/97
PARCEL: 25110CC -00600
SITE ADDRESS •15950 SW ROYALTY PKWY
SUBDIVISION ZONING:
BLOCK LOT • JURISDICTION: KIN
Remarks: Remove and rebuild single family residential fireplace and some dry rot repair.
-- BUILDING - -- - - - --
REISSUE: STORIES : 0 FLOOR AREAS - ---- BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED --- --
CLASS OF WORK.:ALT 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 BD'i : 0 BATH: 0 TOTAL 0 sf VALUE-1: 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 l 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 W00DSTOVES • 0 GAS OUTLETS...: 0
ELECTRICAL ---- -- -- - ---- --
-- RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS -- --- MISCELLANEOUS— — ADD'L INSPECTIONS -
1000 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 - 400 alp..: 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 SIGMA /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1'' amp.: 0 601 +aups -1YA 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 /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: ..
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL 0 SYSTEMS: 0
Owner: — - -- Contractor: ------------ - - ---- TOTAL FEES:$ 96.06
FRANK BASER RODNEY BOBBINS MASONRY
15950 SW ROYALTY PKWY 6162 NE BEACH ST
KINS CITY OR 97224 PORTLAND OR 97213
Phone 0: Phone 8:
Reg 0..: 79273
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 -------- --- - -- - - ---
Footing Insp
Foundation Insp
Fireplace Insp -
Misc. Inspection
Final inspection
Permittee Signature: Issued B Call for inspection -- 639 -4175
S
Plan Che
.TY OF TIGA)2D Residential Building Permit Application Recd By
31i5 SW HALL BLVD. New Construction Additions or Alterations Date Rec 'F 7
'1GARD, OR 97223 Single Family Detached or Attached (e i si , • Date to P.E. `I )2.,P,// ?
503-639-4171 ) 4 1 Date to DST
503- 684 -7297 I Permit to M °�1r 7-0/5 'd•
Print or Type / ` � Called
Incomplete or illegible applications will not be accepted ,. . - ,
Name of Project q - -
Job - -• 6 `i it y - - bt4 I - -- -
Address Site Adds 1 ' Architect Mailing Address
" 5 <A k l t V A I' IL w City/State Zip Phone
X
Name
,14 ice- I
-- Name
Owner Mailing Address ���� ^^ f
' 15 9 go 3 " ,,- `,"i` �1 Engineer Mailing Address
ip
City/State o - 9 I / Phone 7 f -
N I n I/ ( ,, S L h Z� ,/J
City/State Zip , I Phone
' General IZO) ( )2Di✓ r JJ . / , t J Pt Desaibe work New O Addition 0 Alteration 0 Repair 0
Contractor Mailing Addrbss to be done:
/G z KPH � Additional Description of Work: -
City/State Zip Phone • .:a:= :. .. . -
• 1e,,. f- c q ?Z l_3 z-59)?
Organ Const Cont. Board Lira Exp. Date
Attach Copy of t- 2 ,3 -- 9 i{ . . - .. -
Current COT Z29.3
usiness Tax or Metro 0 Exp. Date PROJECT
Licenses , - = V ALUATION $ ' 5o I D. . '
' Name - _.. _- - - •- - - -
Mechanical NEW CONSTRUCTION ONLY: , •
Sub -
M • Sq. Ft. House: - Sq. Ft. Garage . Address
'7•antractor • • Corner Lot YES NO Flag Lot YES . NO '
City/State Zip Phone
(check one) (check one) _
—• -Oregon • • • Cont. Board Exp. Date Restricted • Audio/Stereo 'Burglar -- - - --
- :each Copy of Energy System Alarm
-
Current COT`Business Tax or _ Metro _ 0 Exp. Date Installation Garage Door • - HVAC
LiCen — Opener Systems
P Name Plumbing -- j- -- a all that Other
Sub- Mailing • • • -.. Will the electrical subcontractor wire for all . YES NO
r:ontractor restricted energy installations?
City/State _ Phone Has the Subdivision Plat recorded? NIA YES NO
Oregon Canst Board Li...• Exp. Date Reissue of MST#: Solar Compliance
loch Copy of (Calculation Attached)
Current Plumbin• c. 0 I • 'ate I hearty acknowledge that I have read this application, that the
Licenses l information given is correct, that I am the owner or authorized
COT Business Tax or Metro # Exp. Date agent of the owner, and that plans submitted are in compliance
- _ Name - with Oregon State laws.
°IeCYrical Si' ∎.re of • '; e •ent _ Date
✓%■em -- • - 5 - 1 7- - Sub- Mailing Address ■ ■nta- • - •n Name Phone #
Contractor -
City/State Zip Phone FOR OFFICE USE ONLY:
Plat #: ' Map/TL#
Oregon Ccnst Cant. Bo Exp. Date -
ch Copy of Setbacks: Zone: Solar.
Current ' Electncai Lic. 0 • . Date
Licenses - - • Engineering Approval: ,_ Planning Approval: TIF:
COT Busin - ax or Metro* Exp. 0.
- - i:lsfapp.doc (dst) 1/97
Permit # Account Description Amount Amt. Pd, Bal. Due -
D
MST. Permit (BUILD) �'G S
Plumb. Permit (PLUMB)
• Mech. Permit • _ (MECH)
ELC /ELR Permit (ELPRMT)
State Tax (TAX) 2` j
Bldg: • - - . _ - -
Plumb: -
-
Mech:
ELC /ELR:. - - - - ... _ . _ - - - - --
Plan Check :� _ _
'7-3 - -- - - - -- MST:- --- - - - -- - - -- - - -- (BUPPLN) 3 C
s
Plumb: , . '', "' :"- ' - (PLMPLN) - - - ... - - -- - -
-- - -- - • Mech: ' = - . _ _ . • -� - (MECPLN) _
-- CDC Review - - - -- --- -: --- (LANDUS) -- ' .. .,- .-,`~
tom. - _
- - Sewer Connection - ^ w_ - (SWUSA) - - -- - - . ' -- — - - - -- - -
Reimbursement District ( )
- - - - = 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: - ' CQ • O� • ..
iasfapp.doc (dst) 1/97 - -
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - I
Post/Beam Mech. Shear /Sheath Framing -M c .
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gaso Appr/ dwlk Reins.
Other: / CC 1 P4/L/-- ie✓e��
Date: 5/i i (`'j A.M. , P.M. Entry: o,
Address: I /r • _i.- . / �. / •
Tenant: " te: MST: 97 6 1 3 Z.'
-� / — Z g 9 BUP:
Con /Own: MEP:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Insp. ctor: 0 ' Date: ��
' APPROVED DISAPPROVED/CALL FOR REINSP. CF C�
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 77 - cf3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested to t I AM PM BUD
_ /247 Location / S i� / { _%O � MEC
Contact Person "\ P 67-4 Ol.21 ( PLM
Con „:c•. Ph SWR
BUILDI Tenant/Owner ELC
- ng Wall / ELR
� ,
Footing Ac
ces�� I re-491421d `R 146e 6 Y '
Foundation � F
�; / PS
Ftg Drain (�u
Crawl Drain SGN
Slab .N qu ested SIT
Post & Beam __F Fring Resiarch
Ext Sheath /Shear
Int Sheath/Shear Na-Ing►ee->kion(s1 hi File
Framing
Insulation �6a
D
Drywall Nailing �-
Firewall �S
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Ro f
is
ING
Post fQ
PART FAIL � & s �(
• = ` l!
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
Low Voltage
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 rein pecti RE: l , [ ] Unable to inspect - no access
ADA I tiI \ i l./`
Approach/Sidewalk
Other Dat Inspector Ext
Final
PASS . PART FAIL DO NOT REMOVE this inspection record from the job site.
•