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Permit BUILDING PERMIT CITY OF TIGARD DATE I ISSUED: 12/`8/99'95 -0563 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 839 -4171 PARCEL: 2S 1 15AD -02900 SITE ADDRESS...: 10676 SW TUALATIN DR SUBDIVISION • DOVER LANDING ZONING:R -4.5 . BLOCK • LOT • 10 REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION - CLASS OF WORK.: REP FIRST • 0 sf N: So E: W: TYPE OF USE... :SF SECOND...: 0 sf PROTECT OPENINGS? •- - - --- TYPE OF CONST.:5N ...: 0 sf N: S: E: W: OCCUPANCY GRP.:R3 TOTAL : 0 sf ROOF CONST: FIRE RET ?: OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED: STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD....: 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKLi SMOK DET..: DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 0 Remarks: Roof repair to rafters and soffits due to storm damage. No plans required, fees waived per building official . Owner: -- -- -- FEES RANDEL WHITESIDE type amount by date recpt 10676 SW TUALATIN DR PRMT $ 0.00 R 12/28/95 WAIVED TIGARD OR 97224 Phone #: 624 -8671 Contractor: KENNEDY CONSTRUCTION 315 SE 7TH AVE PORTLAND OR 97214 - - - - - -- - - - -- Phone #: 234 -0509 $ 0.00 TOTAL Reg #..: 003402 REQUIRED INSPECTIONS This peroit is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection ___ ^__ applicable laws. All work will be done in accordance with _ — approved plans. This peroit will expire if work is not started _ — within 189 days of issuance, or if work is suspended for core _ — than 189 days. Perm ittee Signature: Issued By : A r i - - - -- Call for inspection - 639 -4175 Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639 -4171 / Jobsite Address: .' SGT T- a., /ee I/A Off' Subdivision: Lot # Office Use Only Valuation: 3/5 CEO / Contact Date I I Initials Result. New Construction Only: (Square Footage) Planck/Rec # Permit. # c 1 House: Garage: Reissue of Corner Lot? Y N Flag Lot? Y N Map & TL # Zone Owner: get"-/ Wf , t e S d e - Plat # Address: /O IC 7i S IA, v a /4-4 .0 9) r Approvals Required / �� O r q 722 4 Planning Setbacks Solar Engineering Phone: (S ) �tc Other Contractor: /( eiv� ed G'o�vS �i Items Required: Address: 3 4.5- S' i' 7 v f Subcontractors Truss Details Pty ( Cr '77233 Other �t Notes Phone: (5 3) 23 y Contractors License # ©3 110 Z OrQ %f1 (attach cgy of current Oregon license) Contact Name: <G o It z Contact Phone: (ro 3 ) 23 4/" oral Subcontractors: Architect/Engineer: Plumbing: Address: Mechanical: (attach copy of current OR Contractor's License) Phone: ( ) / JOB DESCRIPTION: I? e.p c. it ea ier..S — gc- p ' 0 - 1 7 - P/ / S ' t . a , • - e- 0 p n P,^-�^ � G / c &pa', " 3- �3 Ll 0 ca s Applicant Si nature g-jtke',6 Applicant Phone number _ Received by: r Date Received: /07 /(2._e/9 E� N:1lOgn1QabYeYpp Permit Account Descripdon Amount Ann. Pd. gal. bu e n r Bldg. Permit (BUILD) Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: Mech: Plan Check (PLANCK) • Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) 0 Residential TIF (TIF -R) Mass Transit T1F (T1F -MT) Commercial TIF (TiF -C) Industrial TIP (T1F -I) Institutional TIF (TTF -IS) Office TIF (TIF -0) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 r�,0\W\ �e aS5es5 ►vveNC\ Inspection: Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL: Post /Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing - Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. - Elect. Date Requested: 1 allla VAS' Time: 1 AM PM Address: \ to S W 'f Vo,\ 1 Builder: Permit #: THE FOLLOWING CORRECTIONS ARE REQUIRED: pp ln6 b Inspector: ,hl (ylA; 1 & SLD \1 Date: 19S APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Reinsp. 6 City of Tigard, Oregon Rapid Damage Assessment Form BUILDING DESCRIPTION: OVERALL RATING: (Check one) Name: INSPECTED (Green) . —_1:1 ■C Exterior only . Address: 106 7-6 il'✓ 7! ✓4 / 4 ilk r) v, Exterior & Interior LIMITED ENTRY (Yellow) ❑ No. of Stories: pa i s. h lam, 5 UNSAFE (Red) ❑ Basement: Yes O No O Unknown O INSPECTOR: Primary Occupancy: Dwelling Inspector ID Affiliation Other Residential ❑ Commercial O Office ❑ Industrial O Public Assembly O School O INSPECTION DATE Government ❑ Emer. Serv. O Hospital ❑ Mo /day /year Other Time am pm Instructions: Review structure for the conditions listed below t. Aa ►es '..answer to 1, 2 3, oi: 5js grounds;foi 4 posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY. A 'yes " answer:.to: °'4 requires posting AREA UNSAFE and /or barricading around the hazard. Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and /or barricaded to indicate AREA UNSAFE. Condition Yes No More Review Needed 1. Collapse, partial collapse, or building off foundation ❑ �OV O 2. Building or story noticeably leaning ❑ � ❑ 3. Severe racking of wall, obvious severe damage and distress ❑ .iK ❑ 4. Chimney, parapet or other falling hazard O __I. O 5. Severe ground or slope movement present ❑ 253'' O 6. Other hazard present: O O Recommendations: O No further action required Detailed Evaluation required (circle one) Structurj�' 1 Geotechnical Other O Barricades needed in the following area;. reas: O Other: Posted at this Assessment: Occupants Notified to Vacate Temp Housing Req. • • O Yes ONo ❑ ( Juc— Yes No O Yes No O ? c omments: av• t1•( —. & ci■v.r-ay't._ . — Estimated Damage ❑ 0% Cl 25% O 50% O 100% l $ 5 e' O —Q,c��\ OFFICE USE ONLY 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP 9S 6 Date Requested / AM PM BLD Location /D6 ' .S V /a i -71 AP;//r- Suite MEC Contact Person Ph PLM Contractor 4.12/2 ly A, S L[-_71h Ph 34/ O ? SWR BUILDING Tenant/Owner l��(n� ,✓pry / ELC Retaining Wall ELR Footing Foundation Ac FPS Ftg Drain NOT REQUESTED SGN Crawl Drain fin, FOUND DURING Slab SIT Post & Beam EN O INSPECTION(s) IN FILE Ext Sheath /Shear - -- Int Sheath /Shear Framing Insulation �/ Drywall Nailing � U i .- S S 41 d Firewall Fire Sprinkler / /V S 27 cTrO ".7 Fire Alarm Susp'd Ceiling Mi c t � D�C� 7 � %�-z �1 ,c.�U � C i�� ' GAO Final PASS PART FAIL � � �1 L( -t -/4 c t `cPek -t r2_ 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 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 inspecti . 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 �- /& — Yv Inspe E X t Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Bu iness Line: 639 -4171 eit) q Il BUP Date Requested 1 / 1 I AM BLD Location IF 1J Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/ A 602. e"--81 ( ELC Retaining Wall ELR Footing Foundation Access: / 6-6 / 0 4 FPS Ftg Drain l Crawl Drain Ins pection otes: a_Ak i Uk Slab Post & Beam 5'" r -7 -`� daM Ext Sheath /Shear S hear !� u� d ammg Insulation Drywall Nailing Firewall Fire Sprinkler = / —i 0/1• / / i14VJ _ .• ' . lid Fire Alarm 1 Susp'd Ceiling _I >♦ - _ �, - Roof = 411 .4 4L %1L _� 1 S 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 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 ' Other Inspector Ext / Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . .. .. r .. , . • _... .. .. .... Y ... .. � � • . T v . .� ]9ya.rfS �. • Rcw r .vr -� .Pf t. f -•— . -r'. • . APPLICATION - STREET' IMPROVEMENT /EXCAVATION ,.1A COPY TO: (WHITE) - FILE . ORDINANCE NO. 74 -14 J� (YELLOW) - INSP. , (INSTRUCTIONS ON SEPARATE SHEET) (PINK) - OTHER AGENCY (Bldg (BLUE) - APPLICANT APPROVED (g APPLICATION NO.• - 10 7. NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE AMT.: S 32 PENDING FEE. PMT. ❑ CITY HALL RECEI T O(• c _ 717,9s. r- PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY � DATE 1 ' . L? ! l`14- PENDING AGENCY "OK" ❑ Application and Progress Record / -� ' MAINTENANCE BOND * PENDING INFORMATION ❑ FOR STREET IMPROVEMENT /EXCAVATION AS REQUIRED c ANNUAL ❑ PENDING VARIANCE ❑ EXPIRATION DATE:, • / PERMIT NO.: —1 l0 , DATE ISSUED: 17_ /71 /1 #_ , BY: , /. N. /,. _ -,=z-----.. (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL CONCRETE 1§IDEWALK I& APPROACH AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT Jay Miller Builder, Inc. P.O. Box 23291 Tigard, OR 97281 684 -7543 NAME ADDRESS CITY PHONE - CONTRACTOR - SAME NAME ADDRESS CITY PHONE PLANS BY per City Standards & Specifications NAME ADDRESS CITY PHONE ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 800.00 DOLLARS - (2) EXCAVATION DATA: FOR oa x F s ICEE 800 US 00 .$ 32.00 CMIN. STREET _ DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS /TYPE BY TYPE LENGTH_ WIDTH DEPTH ITEM & QUANTITY _ • STREET _ OPENED Tualatin Drive - see attached - INSPEC- T TION E ' Q U . ESTIMATED STREET OPENING DATE: / / s ESTIMATED STREET CLOSING DATE: / / E D STREET (3) SECURITY NO. SECURITY AMT.: $ 8°0.00 CLOSED SURETY CO.: ` � _ FINAL 7{a - IED CHECI / CASH ❑ B OND c INSPEC. J (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS / CONDITIONS: FEATURES; EXCAVATION LOCATION AND EXTENT. , KI LI } Q 4 — see attached - I u ( I I I �,: I I > I — I r-I 1 I a I • 1 I I CURB "( ■ � _. d. \ _ - _ S. W. TUALATIN DRIVE to - .� ` .. _ • _ _ 7 I ��I W rk S' 1. ( I Site: iub76 SW Tualat n IDri e I 1 I I I (5) NOTE: THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT -OF -WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON. THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS. 1 r� APPLICANTS SIGNATURE: r 1 l' /%.Y DATE / / i 1 i - -- I-------- - - - - -- - -- _ -- - -- '-�_ — - - - -- - i� - - -'� • II AI and Construction Services, Inc. S Tell/ — 0--o 30 9025 Southwest Center Street /t/ P.O. Box 23784 • Tigard, Oregon 97223 (503) 620 - 2086 • FAX (503) 684 -3636 April 17, 1995 Mr. Tom Plescher City of Tigard 13125 S. W. Hall Blvd. Tigard, Oregon 97223 • Re: 10698 S. W. Tualatin Drive Lot 11, Dover Landing Building Permit No. 94 -0308 Dear Mr. Plescher: I have made on on site inspection of the foundation for the above project. I found all work to be done in compliance with the plans. Any variations from the plans have been reviewed and approved. Sine ely, L _ /' . s R. N. o /1 - 1 (( ".V7775-r";,.. , P. E. _MRCGON JRN: � °-`' N,' n. Pd 1 r e rlEs ),N 3fi •