Permit . . . . .
- ' .% • • .. • ,
• • CI T IGARD . . - . ' • - • ,..,-K:' '',
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. ' MASTER PERMIT
• • COMMUNITY•DEVELOPMENT DEPARTMENT PEr4r4 1 T Vi .. . ::..... .. , 2 . MST93•0490
13125 ON :Hallillyd. Tigard..0fegon 3723308131 3 a03i 4 33 . i7-4171 - . . • DATE ISSUED: 09/27/93
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.. • ' . - ' • . PARCEL : ■::-.'8114BB.-20,300 ,
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• - __GITE ADDRESS...'..: 16497 SW_ 10.3RD AVE • ' - ' • •
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• ' SUBDIVISION'. . RIVERVIEW ESTATES -NO.. .2 , • ZONING: R-7 - ' PD -•••• • ` :
•.• ...
:BLOCK...". .... : . LOT ' • . - .047 . - . - .
' ----: - ---: - - - -:- - - - -7 -.-- ---, --, ---: - - - - - - -7 - BUILDING -- • '---- .
- P.E I S r. , - . . DWELLING UNITS:1 • BASEMENT. .. 0 .. • _ i f '
... . . ,- . •
CLASS OF WORK. ;NEW -• BEDRMS:4 • ArrHs:3 • GARAGE ' ' .•475 .. • • sf
.• : - r:;spF... OF USE ;.. ;SF • '. _FLOOR AREAS---------- REQUIRED SETBACKS"--- :-.1------
.. / TYPE . • OF CONST. :5 -;-- FIRST ' -1117 sf LEFT.. :5 • f RIGHT; i 'I: 0. ,t:.. f•bl.,•,••''
OCCUP ,
ANCY GRP.. : R3 „ -,•'. • ' SECOND- . :1284' sf : . '' FRONT 1.2.„0: ft REAR. „ .1. 45 '• f t , .„ , ' .' •
.••
STORIES -s • -2 •.• . -THIRD. - . ;0 ' • sf -. • ' REQUIRED- -••••:7 - , .- , ___........ - . • ..
• ' HEIGHT....... .' ft TOTAL-:-.-----:•2401% sf ' SMOKE` D :Y
,.,- , • , . . • , .,- . .
• FLOOR .1„.:OAD.. - : 40 . 0Sf VALUE - V- • 11, PARKING SPACES....:1 , .,,, ' • • • . : ,
• 11
• R e in al . RATH: I, , ... • .„. - ,,.. .. ., . , ., .
. . .•• " -- - 7 - 7 - PLUMBING -• ` - ' • • .
SINKS.. .. ::,-. "0 :r -.'- FLOOR 'DRAINS ' ..0 ' ., 'BACKFLOW PREVNTRS;xtP ,,•-
LAVA ' ' .4 • ' WATER HEATERS...." ,11 : ' .• -TRAPS.... . . ...... ,..; .4
,. .
- 1 UWISHOWERS.:. ... ,E 3. ' LAUNDRY. TRAYS.... :0 CATCH BASINS... ... . se • ' -,•,' -
WATER ,S • - . • SEWER • LINE (ft ) . :0. • - GREASE TRAPS. .,.• ...'.. 20 - - • ... • ..- , ' :.' .
. ...
• DISHWASHERS. - . :1' • WATER LINE ( ft) .4100 OTHER FIXTURES' . ' • .0,', ". ••. , - .
; sa4.13Bpsg• DISP... :1 -• • -RAIN DRAIN (ft ) ., ;0 . .-
•:! • ' l.-.1''''":-I-T?-4r-141-i•---:.---•--,-_---1-=:=-2=---=-------zr-7------11:11:-1;i4.41--Drvt‘ T r.r.:- --:--= ----: - - - - -- -: - La•- --- z -- - -'• - -,••- '- -•.----=--'------;---------:•:',- -_-'" -.---
• .
7 . . . - .11ECHA'NI CAL - - - - ,-- • • -- -T.- FE .. -.---
FUEL TYPE • '-' ' ' UNIT HTRS.. :0 •• •• type • amount` by ' date' - •vr:.1• • -
_/GAS/ I - •/. VENTS. • .0 BPRT $ 480.5a JH 0 ',-. r.
MAX INPUTi 0 ... ETU VENT •FANS.. :4 .... , BPLC $ - 75.00 JH , 09/277:9 .-, ,, . '. - ,•-,_
FURN < ibil.1K :0 HOODS • • . I , . • BSPC $ 24„ 03- JH .e.1.9 /27// 43 :7 : : ,.- -' " ' • • ' . , .
' RAN )=160P.. _; . :. WOODSTOVES.' :0 SSDC $ • 280.. 00 JH •• 09/27%93 :-.:-• ;
FLOOR -FURN -'. . CLO _DRYERS: .1 PARK $ 500.00 JH 09/27/93 •r--• •• ';..•-`. •:•- '
•
, ' BIM L. /C314. < ' 3HP se OTHER UNITS:1 • • MPRT $ 45.00 ..TH i. 09/27/93 --.. - ,,•'. . '• • •
• :. - -- .. .
- - .BAS' OUTLETS:1 - MPLC -$._ 11.85 .1,H '09/27/93 - - -• -
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• ..:..Owner':. • ----4M5PC $ 2.25 J171 09/27/93 - '
1
SKYLIGHT. HOME- BUILDERS 'CO - • ' , - PPRT $ 14750 JH 09/27/93 - • '
,` • -P -c3 B0X 2,.31b • . , • . PSPC $ •7.38 JI--1' 09/07/93
• . .
A • •• • -. • - TIFF $ - 1520. 00 ...1H 09/27/93 •--.. ,. : .. .
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. ' LAKE 'OSWEGO OR 97035 . ., ' . - • . , . - • '
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' - • Phone - :Pi' 836-2994. ' .' • • ..- • - ' . ' . - • -
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• Contractors - - - •
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SKYLIGHT HOME BUILDERS 'CO
P 0 B0X.2315 . .. .
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. , • • :
. , . LAKE . . •
OSWEGO OR' 97035 • ' . • ' - ,, .. .
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- phone 4t 503--6,36-2994 . ' . - , • • •
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• Reg it•-.: 34086. • •• • • • , ------- • • - - -- - ' •
- •• • : • $ -- 3092.91. 'T-OtAL • S • . •
This perktis issue d subject to the reo ccntaineo in the - . ' . .. ' . REQUIRED INSPECTIONS ' --
I . ' -•- •• -,- •
, • - --,Tigard MuniqipalCode, State of ere. ,S q ay Codes and all otbeil, . . Foot/found .I n sp ` Fireplace In sp ,•:.• -, .. .
' laws: All work 11 be 'don ii ,accordance with approved Post/Beam St rk.iet Gas .L,ine Insp • .,
.• ' - :Pliniolhic pergit will erpire if wiAk •'s not started within 1 , Post /Beam Meehan ••• Insulation n Ins • •
"...', .-- ' . , .
issuance , . or ff work is susp....U for u'ore• than 18 , day's'. ' • %, PI m/unds lab in S'p -.Gyp BOard In sp ,..• . '
. ..
. ' PLM/linderfloor • Rain drain • Trisp - ,-.- • ,''
FirMet•t•ee • Signatidre: :- / .„, ......„,„_•- : IL • -- Mechanical Insp ' :.'1 Lane Insp •.;....-- ..
• • .•, - -e, .- . - ' - 4 .. '''•••' •. ; ' '' • • ,Prumb _Top Out ; . Plopr,/sdtA0.k Insp ' •.•,',
,,Is..7.ue41.13yi ____ • ..••• .
:- - ns:
. • •‘'. ,Framing lIp ..„, . M i_t
eehanal:, Final • '''-''
, „ .. „. • •
r • '' .• ' , • • i • .
- • • - • •
°. . , , ••■ . . „ • , ,-
'. ' • : ', _ .. • ,., C .a. 1 I., : f . or inspection .:7.• 639-417 -. • :' ''• ... '' . '._ • • -. : ,
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'�I ®Y I GAR®. PLUMBING AE EZI+.I T •
PERMIT ' to . o o . : MST93 -0490
• .
COMMUNITY DEVELOPMENT DEPARTMENT . , • - „ 'DATE ISSUED: 09/27/93
1,9125,'SW Hall Blvd.,TIgard. Oregon, 97223.8199 r (503)1339-417i , • .
_ - . , 'P A r CEL 2S1 I. 4BB --E Z 300
S•FTE ADDRESS..;: 197 - SW • 103RD ' AVE . •
' SUBDIVISION. RIVERVIEWE-STATES NO 0 • . 'ZONING: R' -•72 • pp, . • BL K. . . . . •. J L01.... . . . . . ... . .:047 l•' • 1
CLASS, 7 OF WOR'sii .' -NEW- ' GARBAGE DISPOSALS. .' • .'
TYRE - OF' USE...-0;$F' • . WASHING .MACH.- .... :.: 1 , RA�CKFLOW PREVNTRS•..:0 '
:OCCLOAN'CY - GR '..o i R • , FLOOR PR�3INS • • a 0 . • ' .TRAPS '....::.:0
.. • :0 '
- STORIES `` "2- WATER HEATERS' ' . :1 CATCH '0 .... %.,
r_- .i' X TURFS- --_.. -__ _ • LAUNDRY 'TRAYS :0 . SF - RA I N_ DRA I NS..... ': 1
•- SINKS... - ' • 1 - - GREASE TRAPS • ' - -0
LnimICR'IES -4 OTHER FIXTURES... ,
!'U!3 /SHOWERS....: SEWER LINE (ft) ' - '
WATER CLOSETS.. :3 WATER L I.rll • • ('Ft )... a` .: •1216 . - - _ .
DISHWASHERS :1 RAIN DRAIN '(ft)' ' 'DO - • - .
Remarks: PATH I'
OWNER: - - • -- - • ' - ' . _ ___ -F - -- - - -- - - - --
. -SKYL'I GHT,- HOME. BU LDERS CO- , ' - ' - - • : BPRT $ , +800 .. JH ,09/27/93 - , , .
p ti' •Box' 231_ a - - BPLC s 75.100 JH 09/27/93 - • '
• . ` ' f 135F'C $ ' 24.03 3H 09/27/93 - - •
I r ;Ka. 1.cs,scr_r•1- f_1Cx' f-17nl3e� - n
_ _Qcr_.-e - ne 00,71 ru - "TLJ b 7.
_ 9 "rqs-
.. _- .1.
Phone #:-636-2994. - PARK $ 500. 00 •JH 09/07193 - " '- • • -•
• , MPRT $ ' 45.00 JH 09127
- • . -
Plumbing ,Contract-or: •- - •-- . - --••- . -- " - -• -- • ' MPLC -$ . 11.25 ,]N 09/27/93 .
Name: ppRT : 147.50 JH 09/27/93
Address:_ - , P5PC $ 7.38 JH 09/ -27/93 -
- - :City: , • • • • State :. - - TIFF $ 152000 JH '09/27/t33 - _ .
• .4 '� ip1 • - Phone#
' • ,,f.
Reg # . -- '- �. . " ' - - .
--- -- - - -- REQUIRED INSPECTIONS --L-:---- _
- This permit is,�is•sued subject to the re.g- - : , -
'•.e.1'la,tiops• contained in the Tigard Municipal Foot /found Insp,, Rain drain Insp
: of Ore. Specialty Codes and all Post /Beam Struct Water ,Line I- r.sp-'••.
other applicable' l''aws. All work Will be done post /Bea'm •Mechan _ A'p.p''; /Sd•wlk Insp
- in - accordance with, apps - oved plans. 'This r'1 /undslab ,i"i:sp.- Mechanical, f=inal
. - bermit-:will expire - : - if - work - •i's not started - PLM /Uridefloor - ~. ' ' Y•Pl :um•b'.Fiinal- ' .
within 180'd'e'ys. o'f as - or if, work , i:s- • Me'chan•ical•. Ins0 " Top: Out Bu.1i lining• ' ,
,
suspended forte :,more ':t:hari' 1a@ days. Plumb ' _ ' : 'C,ontrol�
. , '. . Framing Insp .�Crawi '•Drain - '
Fi,•eplac •Insp --__
Gas Line Insp _ __. -_
_ ` - Insulation Insp _:
L%'
V aa Gyp Board Insp -
duthorii•ed Plumbing Contr •Signature . - , . .
. . ; Cali for ", l inspection - 639 -4175 '
_Contractor Notes: • '
131isswHaU PLNCK /RECT # � 'J�
CITY OF TIGAIRD Tigard. 97223
PERMIT a /n 9 1/f 0
COMMUNITY DEVELOPMENT DEPARTMENT
(503)63'x"' DATE ISSUED
JOB ADDRESS: /6 St,. /03 n - TAX MAP /LOT 25/ /46e. e. I`LIO/
SUB: t(L I)R w fJ ii J iOT: L17 LAND USE: R '7 ( I))
VALUATION: / 9 f g,
OWNER SPECIAL NOTES
NAME: SKt-� %b13� Ncm� gun° girl' C- REISSUE OF:
ADDRESS: rp4 x„, Z3/ LAST REISSUE:
U (64‹ , e O Jrb••fi"6 2 0/. _ q 70.35 FLOOD PLAIN/
PHONE: 636 -Z SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED S1115'9° - CX)/ Y
NAME: S PLANNING: �? ' d `
ADDRESS:
ENGINEERING: (SIiti?id l/iti)
FIRE DEPT:
PHONE: OTHER: TI 9 r
CONTR. BOARD #: " EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB:it - O TT V LIST /SUBCONTRACTORS:
MECH: ITv e N-2 - BUS TAX: •
• ARCH /ENGINEER V CALCULATIONS:
NAME:c 6 4 ' — ing V V TRUSS DETAILS:
ADDRESS: • OTHER:
•
•
PHONE:
PROPOSED BLDG. USE: S 5�-
COMMENTS: / �.,,..
A' ANT SIGNATURE
Received By: Date Received: 7- Z/ `43 .
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
A563- 10 -432 00 Building Permit Fees ilrD -.SO ' yv
10 -431 00 Plumbing Permit Fees P/7.50
I ? Sb
10 -431 01 Mechanical Permit Fees f /S• ce eir "
10 -230 01 State Building Tax (5%) 334/ 33 •
Building a /,v3
Plumbing 7.3e (
Mechanical .
10 -433 00 Plans Check Fee ��vX 1/0 4/6 4C
Building 7.160
Plumbing
Mechanical 11.15
10 -230 06 Fire
SwRff.3400 30 -202 00 Sewer Connection -22°0
2.2 °0
30 -444 00 Sewer Inspection -3, .33" .r
25- 448 -02 Commercial TIF Fees
25- 448 -04 Industrial TIF Fees
25- 448 -06 Institutional TIF Fees
25- 448 -03 Office TIF Fees
25- 448 -01 Residential Traffic Fees /I/0 -" /(//0
25- 448 -05 Mass Transit TIF Fees / /0 /1
52 -449 00 Parks System 0ev Charge (PDC) SO v
31 -450 00 Storm Drainage Syst Dev Chrg
(SSDC) ,24f1)
24- 445 -01 Water Quality (Fee in lieu of)
24- 445 -02 Water Quantity (Fee in lieu of)
TOTAL 6327.
nm/3587P.WPF
3 %7( L/(
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON 155 NORTH FIRST, DEVELOPMENT LSBORO, OR 97124
COUNTY, INSPECTION REQUESTS: 503 /640- 3561/693 -4415
PHONE: 503/648-8761 O 5,6
OREGON Page : 1 o f 1
Date : 03/07/94
Time : 14:36
Permit Type : Residential Electrical Permit Permit # : 05050643
Permit Status : APPROVED Applied : 03/07/94
Situs Address : 16497 SW 103RD AV TI Issued : 03/07/94
Permit Title : SFR - BURGLAR ALARM /LKBX 'SKY' Completed :
Permit Descr. : LIMITED ENERGY To Expire : 09/03/94
Project Title : SFR - ELEC /NEW HOUSE Project # : P0036508
Project Descr. : * EROSION *
Parcel Number : 251'1'1 - Land Use District :
Valuation 0
•
Legal Descr.
Owner : INSPECTION - TIGARD Construction : OTH
Applicant Name : TENNATRONICS ALARM CO Classification : 900
Applicant Addr.: PO BOX 883 Occupancy : R3
OREGON CITY, OR 97045 Validated by : KF
Applicant Phone: 656 -6333 Inspector Area :
CONTRACTOR : TENNATRONICS ALARM CO. OF OREG Lic. C 3 -255C 656 -6333
Fee description Units Fee /Unit Ext fee Data
Limited Entegy /Alter. /Extension 1 40.00 40.00
Subtotal Electrical Fees: 40.00
State Surcharge of 5% 2.00
Total Electrical Fees: 42.00
* ** Fees Required * ** * ** Fees Collected & Credits * **
Method Check # Receipt No. Date Payment
�.. CK 6396 03/07/94 42.00
TOTAL THIS DATE * * * * * * * ** 42.00
Fees: 42.00
Adjustments: .00 Total Credits: .00
Total Fees: 42.00 Total Payments: 42.00
Balance Due: .00
NOTICE: This permit becomes null and void If the work or construction for which It is Issued Is not commenced within 180 days. Once construction has started,
the permit becomes null and void if construction is interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or agents In support of this permit is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading information may invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is issued
specifying that the use or occupancy of the building or structure is provisional and revocable until the satisfaction of all inspection requirements.
APPLICANT'S SIGNATURE
INSPECTION NOTICE ii
City of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223 14( Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 1
Inspection:
Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post /Beam Struct. San. Sewer Framing
Post /Beam Mech. Rain Drain Insulation
4 �
Plbg. Underfloor Water Line Gyp. Bd. 'ech.
Date Requested: — Z g6`- / * Time: AN PM
Address: zc /5 / 7 �, / Permit te T(3-04110
Builder: 6 7 d - 7 � g
THE FOLLOWING C CTIONS ARE REQUIRED:
�
Inspector: S / Date: 3 -n ^�7
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
. WASHINGTON COUNTY RESTRICTED
Department of Land Use & Transportation
Aft ^ Electrical Inspection Section
v 155 North First Avenue, #350-12 ELECTRICAL ENERGY
Hillsboro, Oregon 97124 APPLICATION
Information: (503) 640470 0 Fax: (503) 693 -4412
PLEASE PRINT .
• Please complete all sections, 1 through 5. Project No. Permit No. •
1. Location of installation Label No. Date - 2
Address i 6 si• q I S.(_L) . I n - 3 (La Issued By Office
City Q A fL d , OP— _ Zip Code 4. Type of work:
Tax Map Map No.
RESIDENTIAL Restricted Energy Fee $40.00
Thomas Map Book: Page Section (for all systems)
Directions Check type of work involved:
La C..14.- rvox 1.(.... '�
Commercial Audio and Stereo Systems*
ommercial
n Residential S : urglar warm
Tenant Name i Telephone Systems*
(if commercial) • Garage Door Opener*
This permit becomes null and void if the work authorized by the • Fire Alarm
permit Is not commenced within 180 days from date of issuance
of such permit or H the work authorized Is suspended or abandoned Heating, Ventilation and Air Conditioning Systems*
at any time after work Is commenced for a period of 180 days. II Vacuum Systems*
Electrical Permits are non - refundable and non - transferable. • Other
2. Contractor application: 1 /� COMMERCIAL Fee for each system $40.00
Electrical Co tractor l T 'E li , T�Q 1V ! C-S A LA 2. 4/, l.U, (see OAR 918 - 260 -260)
Address ro e DX R g OII.Fjo>•.) '1 7 ' . 9 76 Check type of work involved:
Date 3 - 4 -94- Job Number / typ
Property Owner S K/ L L q i.I T �/O 1Nf r&
Contractor's License No. V 3 -. 2 - C. L E. — Boiler Controls
Contractor's Board Reg. No. t� 9 9 31 _ Clock Systems
Phone No. 6, • — 6,133 Data Telecommunications Installations
— Fire Alarm Installation
3. Owner application: - HVAC
Instrumentation
Print Owner's Name Phone No. _Intercom and Paging System
Landscape Irrigation Control*
Address Medical
—
Nurse Calls
City State Zip Outdoor Landscape Lighting*
This permit is Issued under OAR 918-320-370. The applicant agrees Protective Signaling
—
to make only restricted energy Installations (100 volt amps or less) Other
under this permit and to do the following: —'
1. Only use electrical licensed persons to do installations where
required. (Certain residential and other transactions are exempt Number of Systems
from licensing. These have asterisks ('). All others need licens-
ing.)
2. Call for an inspection when all the Installations under this permit ' No licenses are required. Licenses are required for all other installations.
are ready for inspection.
3. Purchase separate permits for all installations that are not ready 5. Fees
for inspection when the inspector is out to inspect under this
permit. Enter fees $ 4 0
4. Assume responsibility for assuming that all corrections required Z
by the inspector are done, and 5% Surcharge .05 X total above $
5. Assume responsibility for calling fora final Inspection when all of g ( )
the corrections are completed. //,,
The person signing this permit must be the appiican a person Total $ `-
authorized to bin • \ the applicant.
Signature W
1 r , ,_� '' I Space below reserved for validation.
•
Authority if other th:N. •plicant �� A3 .r
i
For Inspections call
640 -3561 or 693 -4415 .
24 -hour recorder, one working day In advance of need 11/92