Permit I . /
C1TYO TIGARD MASTER PERMIT
F PERMIT #: MST1999 -00317 •
j l p DEVELOPMENT SERVICES DATE ISSUED: 09/22/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12492 SW WINTERLAKE DR PARCEL: 1S134CC -03400
SUBDIVISION: CAPSTONE ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
REMARKS: Fire damage repair to garage
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: REP HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: si FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 18,000 00
OCCUPANCY GRP: R3 • BDRM: BATH: TOTAL: sf REAR:
PLUMBING •
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 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: 1 0 - 200 amp: 0 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: SIGNAUPANEL: 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/1RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 8 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 404.76
This permit is subject to the regulations contained in the
BRUCE HILLYER LORENTZ BRUUN CO INC
BRUCE
SW HILLYER
LAKE L N Z BR UN Tigard Municipal Code, State of OR. Specialty Codes and
12492 TIGARD, OR 97223 PORTLAND, OR 97242 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 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
Rep 8: LIC 00000033 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
Electrical Service Electrical Final
Electrical Rough In Final inspection
ORIGINA
Framing Insp
Insulation lnsp
Rain drain Insp
Issued By : // Permittee Signature : , A
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Gilt( OF TIGARD - Residential Building Permit Application Plan Check# ° I ' - SSSG
13125 SW UiALL Alteration - Interior Only Recd By
Date Recd - Z0
{ TrGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. -_/ - 9 '
V 503 -639 -4171 Date to DST - -r/
F 503 -684 -7297 1 111 Permit #I'V15TO' /-Q03('I
Print or Type Called 9 /
Incomplete or illegible applications will not be accepted
Name of Project Name
Job sc c -• \ \ \.kk
S Architect Mailing Address
site Address
Address \25--VIV2 l\akC._
e City /State Zip Phone
Owner Mailing Address Name
\ --k - W;,.kcc \o�
g
City /State Zip Phone
Engineer Mailing Address
-7 :0"vA CS 52y - t-{$•( o
General Nenie City /State Zip Phone
Contractor \-sptc - Cu • / - ZA•C Describe work New 0 Addition 0 Alteration 0 Repair
Mai kg g Addre to be done: F■rcca� 1
t� - Ctv°g IS�in� Ctc■ '
As
Prior to permit s tric X12.\ 8$ Additional Description of Work:
issuance, a copy City/State Phone ‘cA cct\ Pq C \ V.4.AcE.�
of all licenses �� �1 (-1-44754 2 CC
... - tq1- -V \-.
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# 2 ? CAoe VALUATIO $ l $ • °C. database -
- M -Name NEW-CONSTRUCTION -ONLY:
Sub- Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Indicate the restricted energy installation by the electrical
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- 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 Solar Compliance
of all licenses are Oregon Const. Cont. Board Exp. Date (Calculation Attached)
required if Lic.#
expired in COT I hearby acknowledge that I have read this application, that the
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 Si. at e s 9y�n /Agent Dote
Electrical cr∎z.or.E \c- R` :f9: /' ` \v scc
Sub Mailing Address Cont ct Perscin Name Phone #
Contractor �e��b ` � ° LO" m� •
ontractor s��R1��{3l3
`�/ FOR OFFICE USE ONLY: 599 t701(5
City/State Zip Phone Plat #: Map/TL #:
Prior to permit s \`tr.9 CQ. 9105 ‘ 3'3 _ it- ( 3 Cr -3 �-fl)
issuance, a copy 1 Setbacks: Zone: Sola
of all licenses are Oregon Const. Cont. Board Ex .Da / T S /�
required if Lic.# � - i y
expired in COT L o ' I Engine ' Approval: Planning proval: TIF: A I�/►__
database Electrical Li # Exp � to q -, � [) I�Y'1 N ft
1 V I`'T
Electrical u e sor Lic. # . Exp. Da
\� 0 , f v PPS
` ( .
i:forms\sfintalt.doc (DST) 10/23/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 199 9— 003/ 7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested ) S t) AM PM BLD
Location ) 2. Li / Z .4) 1 Suite MEC
Contact Person Ph 3V PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation F oy, FPS
Ftg Drain 1 5,1564— 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
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
PASS PART FAIL
ECTRIC�
Servi
Rough In
UG /Slab
Low Voltage
Fire Alarm
y
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 reinspecti•n RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D la �
Other p
nS I actor Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION q q -cog/7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM__PM BLD
Location 12-11 2 IA t 1� V-, Suite MEC
Contact Person TG;,rYI.Q/J PLM
Contractor Ph SWR
JILDING` ' Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: •
—
Slab� ✓V} SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear 1 /'
Framing � V`' — 551A-kS
Insulation 1
Drywall Nailing [}(�( ,Pic
Firewall 1
Fire Sprinkler Alarm ; A/� 2 j `f,,/� ( / �,
Fire Al �� G�^� �^ '"' " \ � ` 1 t~/✓L C4'
Fire Susp'd Al Ceiling
Roof _ l
Misc: _ • ��
• 4 ' PART FAIL AV
PLUMBING
Post & Beam
Under Slab .
Top Out �C�, - S 7 C)�1.
Water Service V �
Sanitary Sewer
Rain Drains
Final L O O
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: [ ] Una le to inspect - no access
ADA A�
Approach/Sidewalk Date ) I VD b Inspector Y (. CA Ext t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.