Permit •
A 4 CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00067
-- 1 DEVELOPMENT SERVICES DATE ISSUED: 03/20/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 0911 Z1
SITE ADDRESS: 11815 SW WILDWOOD ST IGINIAl. PARCEL: 2S110BA -05300
SUBDIVISION: SHADOW HILLS ZONING: R -2
BLOCK: LOT: 012 - JURISDICTION: TIG
REMARKS: Remodel master bedroom from 2 small bedrooms, reconfigure bathroom and add 225 sq ft new
second story deck.
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: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 15,000.00
OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: sf REAR:
PLUMBING
SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: - TRAPS:
LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER:
• FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 1
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: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 ,- 400 amp: , 201 - 400 amp: 1st W/O SVC /FDR: SIGN /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: $ 459.99
SIBLEY, BARBARA D OWNER This permit is subject to the regulations contained in
SIBL Tigard Municipal Code, State of OR. Specialty Codes and
11815 BARBARA
WILDWOOD D ST
1181 OR DW all other applicable laws. All work will be done in
5 SW
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
Rea #: 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
Underfloor insulation Electrical Rough In Electrical Final •
PLM /Underfloor Framing lnsp Mechanical Final
Mechanical Insp Gas Line lnsp Plumb Final
Plumb Top Out Gas Fireplace Final inspection
Electrical Service Insulation Insp Building Final
Issued B 1
Permittee Signature : e I � '
II
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
CITY " TIGARD Residential Building Permit Application Plan Check # 3 10
13125 SW HALL BLVD. Additions or Alterations Rec'd By
Date Rec'd 3 .... 00
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. - 7 -00
V 503 - 639 -4171 II
' Date to DST 3 1 3 - 0 0
F 503 - 684 -7297 1 / rmit # �lr 7
Print or Type C Iled i7 od -
Incomplete or illegible applications will not be accepte A 0 •g.' li,
Name of Project Name
Job SfP ven '.'y-5
Architect Mailing Address
Address Site Address 9 7zzi/ r 7 c /0 5LD Ern? Wood
0/.5- SW W /LOWOOD ST T /6ARAo City/State _ _ / n Zip Phone
Name
Name T 13 Al f o % �f 2Z 3 2,V6
��F3/e,9 Si C3G E y �J
Owner Mailing Address
// 8/5 SLJ W/L.OWo°b ST Mailing Address
City /State Zip Phone Engineer
T /GARS 9 "IVY City /State Zip Phone
General Name
•
Contractor 7 Describe work New 0 Addition Alteration, . Repair 0
Mailing Address to be done:
Prior to permit Additional Description of Work: 5 ,,.0" .bearee''''s , Re.ce •-rly°st
issuance, a copy City /State Zip Phone Rew...bd.e(: Mu.,Teer ;re... Z b,T>^ ,-) Jerk-
of all licenses G ° i-
are required if Oregon Const. Cont. Board Exp. Date PROJECT t�
expired in COT Lic.# VALUATION $ /.5 660
-- database _ _
Mechanical Name NEW CONSTRUCTION ONLY'.
Sub- T/30 .Sq. Ft. House: 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 following areas
of all licenses Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing Name (check all that Other:
Sub- T D 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. Cont. Board Exp. Date ',
required if Lic #
expired in COT / I`h arby acknowledge that I have read this application, that the
i
database Plumbing 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 i Signature of Owner /Agent - Date ' Co )
Electrical 7-E D % .- _ ,a,, . k _ � . ��� 2 Z
�ontact Person Name Phone # H °.y.E
Mailing g Address
\ l cr6er r0. 56I,, w14t635- -1 603 i /g/V
Contractor (1)G Soinr sor wK 63c-1-01 0 ■
City /State Zip Phone �e - t( 3 -4 - I- __ ,
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# Plat #: , /� 4 &e, Ij0�2 d _65 Q
expired in COT oN I 7 �U'r!
database Electrical Lic. # Exp. Date Setba . ks: Z Solar:
Electrical Supervisor Lic. # Exp. Date Engiwring Approval: Planning Approval: TIF:
y/ --
/ / O. 66 Q i:\dsts \forms\sfaddalt.doc 9/8/99
Permit #: H vT 4P40O -'
0
F
/ .\ Address: /1 ` / 560 4)4 p Goo01 5p -
: t� . ; > �•�_, 11 o
' .. 4 .7.0.: ! LMfir :IZ
-" ' Issued by: � Date: 3 .2 a -
I: g9
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: - - - _ -
1. I own, reside in, or will reside in the completed structure.
ri A 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
❑ 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.
OR
0. roe 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 Property Owners about Construction Responsibilities on the reverse side of this form.
?fatlitIf■ta) ,...dadeejf
/ /&V
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
]Info ration Notice to Property Owners
Abut Construction Respo �sib6Dft s
Note: This Information Notice to Property - Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPL*YER RESPONSDl OLlTDI S
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax flaw: As an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments•even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091: .
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon.Employment Division at the Department of Human Resources
at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must '
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you,may
be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information,
call the Workers' Compensation Division at the Department'of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1- 800 -829 -1040.
OTHER RfESPONSD TES AND AREAS OF COI(lCEItiN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray. water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise:' Make sure you have the expertise to act as your owri general contractor, to coordinate the work of rough -in and finish
trades, and to notify building officials at the appropriate nines so they tan perform the required inspections.
-
If you have'additional questions, write or call the Constructidn CantracteSrs Board (PO Box'14140,- Salem; OR 97309 -5052,
503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop- own.pm4
1 /94 •
r''`''ITY'OF TIGARD.BUILDING INSPECTION DIVISION ttOv_Gv. i
, r - 244tiour Inspection Line: 639 -4175 • Business Line: 63
. p 639-4171 / SI ,
BUP
Date Requested ! --.1 A , �`� PM BLD
Location 1/ 1 h 5 ' Wl / w 14/ s f ' Suite MEC
Contact Person jil/Y7 Ph ,54/ - G 2 ZL 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
Roof
Misc: _ — _ _
Final
PASS PART FAIL -
Post & Beam
Under Slab - .
Top Out 54.,.�.-
Water Servi ��'
Sanitary Sew
Rain Drains
F
PART FAIL
ANICAL
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 9/) a I n spect or \ " v`' C /
Other EXt�1
Final ~ - ' ' _
PASS P r , FAIL DO NOT REMOVE this inspection record from the job site.. -
CITY OF TIGARD BUILDING INSPECTION DIVISION /Z MST AU'UUU�o
24- Hour,h speetion Line: 639 -4175 Business Line: 639 -4171
■ • BUP -
Date Requested "7 3 AM PM BLD
Location /J8 5 $ - t"/ Suite • MEC -
Contact Person - Ph .54/ — b Z Z PLM -
Contractor l/ PP / h L SWR
BUILDING Tenant/Owner P/1G� C4, (rZ /w aAI,Gw(, ELC
Retaining Wall - 7"— / L- 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
Roof
Misc: _
Final •
PASS PART FAIL _
CPLUMBIJ
Post & Beam
Under Slab
•
Top Out
Water Service
•
Sanitary Sewer _
Rain Drains
ART FAIL
NICAL
Post & Beam -
Rough In
Gas Line • -
Smoke Dampers —
Final '
PASS PART FAIL •
Service •
Rough In - -
UG /Slab
•
Low Voltage
Fire Alarm • . • .
Ina
PART FAIL
BackfilUGrading
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 r inspection RE: V Unable to inspect - no access
ADA
Approach /Sidewalk
Date 3 l3 Inspector
o
Other Ext
Final
PASS PART • FAIL • DO NOT REMOVE this inspection record from the job site
' CITY OF TIGARD BUILDING INSPECTION DIVISION MST WOO doo -- 7:
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested g --- oZ9 AM PM BLD
Location I) q / 8 604:1-06,(/0-,¢," Suite MEC
Contact Person MA .c.;-6-(2-01. Ph 3 i - O. - 2 - ( PLM
Contractor Ph SWR
BUILDING Tenant/ ELC
Retaining Wall ELR
Footing Access: -
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: S
Slab v2° i SIT
Post & Beam
Ext Sheath /Shear i ())12
men
Sheath /Shear r �?
Framing .
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: - C/0 Fi
-_ —
PART FAIL
C7 -
P
iC) LUMBING
Post Beam
_ Under Slab
Top Out •
Water Service
• Sanitary Sewer
Rain Drains •
Final
PASS PART FAIL
MECHANICAL
Post & Beam -
Rough In -
Gas Line
Sn•.e P ampers
P • 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 8 - 9 — " / Inspector - EXt
Other P
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •
CITY OF TIGARD BUILDING INSPECTION DIVISION M Gov -004167 24 -Hour Inspection Line: 639 -4175 .Business Line: 639 -4171 '
• BUP
-- Z--00 D
6' 3 ' / O Date Regquested AM PM BLD
Location l 1 0 / 5 / a///406V Suite MEC
Contact Person 41 Ph 3 I ( D z 7 -r° PLM
Contractor Ph SWR
41UILDINO Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain •
Crawl Drain Inspection Notes: QQ , / SGN
Slab 2 "util rJ SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear,
Framing
ul�io
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fina
A 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 [ ] 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
Other Date 7-12. - U Inspector Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST woo-0°6607
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171
BUP
Date Requested 5 3 00 AM PM BLD
Location ( I / S k)/) L Suite MEC
Contact Person la / / IL Ph (Q q `7 '" 1(.Q qd p PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall E LR
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
Roof
Misc: _
Final
ART FAIL
PLUMB
Post & -earn
U lab
op 0
Water Service •
Sanitary Sewer
Rain Drains
Fi
ff.ASW 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 V other Date S / 3) 6 Inspector �" U Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION I , sT.�D — GGG
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP •
Date Requested ,,7 y�Q�/ AM BLD
Location /1 f"J / zAJ 4 i/ u1cc /2 57 Suite MEC
Contact Person Ph PLM
Contractor Ph 3 Lf G 2-1 ,6 SWR
BUILDING Tenant/Owner ELC
• •ng Wall • ELR
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam '
Ext Sheath /Shear
Int S ath /Shear
rmin.
InsuTation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof _ - Misc: _
F•
PAS PART FAIL
BI NG
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
P ASS PART FAIL
Service -
ough In
Low Voltage
Fire Alarm
F'.-
1 - ART FAIL
S
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspectiori 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 Inspector 7
Ext
Other
Final
PASS PART FAIL DO NOT- REMOVE this inspection re cord from the job site.