Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00204
A li , -DEVELOPMENT SERVICES DATE ISSUED: 7/10/00
I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09620 SW SHADY PL PARCEL: 1S125DB -10200
SUBDIVISION: THE RAZBERRY PATCH ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REMARKS: changing entry way
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf . FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 2,100.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 0 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT . SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 • 200 amp: 0 - 200 amp: W /SVC OR FDR: 0 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SI
GN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
• Reconnect only:
>=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: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: - DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 183.00
This permit is subject to the regulations contained in the
DAVID MURCHE DANIEL L. OSMON Tigard Municipal Code, State of OR. Specialty Codes and
9620 SW SHADY PL 17801 SE HWY 224 all other applicable laws. All work will be done in
TIGARD, OR 97223 CLACKAMAS, OR 97015 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
•
• work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 108566 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Footing lnsp Electrical Final
Electrical Service Final inspection
Electrical Rough In _
Framing lnsp .
Insulation lnsp
I"
r \
Issued B Y Permittee Signature : �Y' ��
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day .
Plan Check # 7 -7/ /e
CITY OF _TIGARD Residential Building Permit Application Recd By / T
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd 6 -, 4, -cO'
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 6/23 a7) `/
V 503- 639 -4171 Date to DST -2 -6 a
F 503- 684 -7297 /`7 Permit # MST„ 2D -rn Do
Print or Type Called 7'7 -4o s. p
Vrt-t
Incomplete or illegible applications will not be accepted 52.-A .fr -rte
Name of Project Name •
Job Muzet /X
Architect Mailing Address
Site A ddress
Address , 9
cm, 7 6 Ss w- ,S ii w" )/ P1 City/State Zip Phone
Name
0)3„k.:3. ,
�1
tjv 1-0-- Name
Owner Mailing Address
6 11, U S•Ltl Si11 f f 9
City/State Zip Phone Engineer Mailing Address
1 k ► „-- o(( `11,223_ "/5 -1 -11J
General Name City/State Zip Phone
DiG-L L . OSr
Contractor �� 05 yvtp„� �pS: c ,iA d f��^o 94 Describe work New 0 Addition Alteration Repair 0
Mailing Address to be done:
Prior to permit 1`7 Bo/ S 4ta y . D-D-(1 Additional Description of Work:
issuance, a copy City/Stat acJ�,.44 - Zip 1 ” Phone .47/7 To f5FiA •R' E/D � e -
ct
of all licenses ryrv- 0 9`701 S -Sin (D SS
are required if Oregon nst. Cont. Board Exp. jOate, PROJECT
expired in COT Lic.# / go 1 -'' ' VALUATION $ � � U' <
database 9 % of o I
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- N R Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City/State Zip Phone (check one) (check one)
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarm
expired in COT Lic.#
database Installation Garage Door HVAC
Plumbing Name Opener - Systems
Sub- AI/ (check all that Other:
Contractor Mailing Address apply)
Wll the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A YES NO
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date - - -
required if Lic.# Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
Name - agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Electrical Lt.) \/■-€11Z.. Signature of Owner /Agent Date
S Mailing Address
Contractor ktact Person Name Phone #
City/State Zip Phone
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat #: Map/TL #:
of all licenses are Oregon Const. Cont. Board Exp. Date / 5 /?5P6'-
required if Lic.# Setbacks: Zone
. expired in COT
database Electrical Lic. # Exp. Date i
5
Engineering Approval: Planning Approval:
$1/4)-10 ^-- I:SFREM.DOC (DST) 4/97
Permit #: H m " 0 000 - CO PO
/ o F
�� , � 9(O?O � r -b y< Pc..
A. �, Address:
=. :
°. j ' Issued by: 497 Date: ��o
I = 5
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
F - 4 / 1. I own, reside in, or will reside in the completed structure.
I 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
I before or upon completion.
Ei 3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
11 OR
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Propert I ners about Constru tion Responsibilities on the reverse side of this form.
cti j fI ( 2 -lo —ad
Signatur f permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
OWNER
Electrical Signature Form
Permit #: MST2000 -00204
Date Issued: 7/10/00
Parcel: 1 S125DB -10200
Site Address: 09620 SW SHADY PL
Subdivision: THE RAZBERRY PATCH
Block: Lot: 022
Jurisdiction: TIG
Zoning: R-4.5
Remarks: changing entry way
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
DAVID MURCHE OWNER
9620 SW SHADY PL
TIGARD, OR 97223
•
Phone #: 452 -4193 Phone #:
Reg #:
AN INK SIGNATURE IS REQUIRED N THIS FORM
X ,,. .� //j
Signature of upervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD 24 -Hour
aUILDING Inspection Line: (503) 639 -4175 MST 2v 1)6 a ( ('
IY'l F ECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Re uested 3- - 7 AM PM BUP
Location 7' 2- D PL— Suite MEC
Contact Person Ph ( ) q 3 PLM
Contractor Ph ( ) '°? t - $ '- 5 SWR
�UILDIN Tenant/Owner ELC
Footing
Foundation � ELC
Ftg Drain Access: V C.A ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ' /�� O L J G �s T P
Int Sheath/Shear /
Framing (c) . C�°' Psi Ci"c f
Insulation
Drywall Nailing 2 ( G-
Firewall / � - 7' /-
Fire Sprinkler 1 ��,/
Fire Alarm
Susp'd Ceiling
Roof
Ot
Fin.
_,_-�__�, PART FAIL
• BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
RI 1
ervice
Rough -In
UG /Slab
Low Voltage
Fire Alarm
X11 PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA 7-0)1-•-•-• Approach/Sidewalk Dat 3 /1 ' 0 ) Inspector
Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
'.4UILDING Inspection Line: (503) 639 -4175 r1 its 0,� O J? J c�
IIt PECTION DIVISION Business Line: (503) 639 -4171 O
BUP
Received 12 / Date Requested AM PM BUP
&'
Location / Sz le L . Suite MEC
Contact Person Ph ( ) #5 )- -1 q 3 PLM
Contractor Ph ( ) -- // SWR
UILDI ` Tenant/Owner m �� C Q ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: eilesb � — --- SIT
Post & Beam (../446.41
Shear Anchors / � Ext Sheath/Shear ri��, / f -
V `/ •
Int Sheath/Shear
Framing
Insulation /34 /6 -> -5 ;) ���
jA -
Drywall Nailing 7 '-f` CIAA, I , , ,� -- /�
Firewall L�-Q YV Q S S 'L y2 ` ( r 4, 1 `7 3
Fire Sprinkler �7
Fire Alarm
Susp'd Ceiling '../S--1°3 ('� A-(---
Roof , \ b
Other• ny
anal) L P ./)-k.SS,
ASS PART FAIL
PLUMBING
Post & Beam L L 61 < elf Q q _� 2w—
Under Slab '` f'
Rough -In Me s Sa e ���t 194. o p
Water Service 8
Sanitary Sewer /
Rain Drains
Catch Basin / Manhole ` /�"�O 3 R. : �� �� i ik./(J� Gl./ //'/
Storm Drain / �/ Q }-� (� • Q
Shower Pan f e C / \ Ze '� `- cbiZ—
Other: )
Final 6 ?if / L"ti✓0 , C
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
LECTRIC 1
'k. 6ervice
Rough -In
UG /Slab
Low Voltage
Fire larm
in ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION MST aZCOO- oo2011
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
C BUP
Date Requested 7 - / AM PM BLD
Location f 2-6 ,5C' - Suite MEC
Contact Person / Ph « 4/ 93 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling / 1 �S g l l C4 /� C VI h r ui bOA e s —
Roof / o h x
Misc: r
��� Y � Y�!/#'LG`� ��J/ re
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
PA,sS ART FAIL
tLECTRICA
Service
h In
UG /Slab
Low Voltage
Fire Alarm
F.
ASS PART FAIL
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: 4 [ ] Unable to inspect - no access
ADA
Approach /Sidewalk sp /J
Other D Inspector ! %� `� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION erP GU _G 6).2at
24 -Hour Inspection Line: 639 -4175 q (PD�1/O
Business Line: 6399 - 441
BUP
Date Requested / — / f BLD
Location 962-V .5A ,5 4c:17 Suite MEC
Contact Person Ph UfL- — g/ f .3 PLM
Contractor Ph SWR
L 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
ram'
r o
(Drywall Nailin
'Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: ;
Fin
PART FAIL
- . ' BING
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 [ I 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 /l
Other Date v Inspector ` ExtS
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.