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10580 SW PATHFINDER WAY t. City of Tigard, Oregon Rapid Damage Assessment Form BUILDING DESCRIPTION: OVERALL RATING: (Check one) Name: INSPECTED (Green) ❑ Exterior only Address: 0 5 $ 6 S\A) A v3, Exterior & Interior LIMITED ENTRY (Yellow) ❑ No. of Stories: UNSAFE (Red) O Basement:. Yes O No ❑ Unknown O INSPECTOR: Primary Occupancy. Dwelling CI Inspector ID Affiliation Other Residential O Commercial CI Office ❑ Industrial O Public Assembly O School ❑ INSPECTION DATE: Government ❑ Emer. Serv. O Hospital CI Mo /day /year Other Time am pm Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2, 3, or 5 is grounds for. ,,�..., 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 .., ❑ ❑ ❑ 2. Building or story noticeably leaning O ❑ ❑ 3. Severe racking of wall, obvious severe damage and distress O ❑ O 4. Chimney, parapet or other falling hazard O ❑ O 5. Severe ground or slope movement present O O ❑ 6. Other hazard present: ❑ O ❑ Recommendations: ❑ No further action required ❑ Detailed Evaluation required (circle one) Structural Geotechnical Other O Barricades needed in the following areas: O Other. Posted at this Assessment: Occupants Notified to Vacate Temp Housing Req. ❑ Yes CI No O Yes O No CI Yes ❑ No O ? Comments: * orc , r - cs%R , ' w ;, r of kov00 ,-Q ^ x Se. �a.r, cR 9. Q Estimated Damage O 0% ❑ 25% ❑ 50% CI 100% $ OFFICE USE ONLY 1 1 January 2, 1997 CITY OF TIGARD OREGON 10581 SW Pathfinder Way RE: 1995/1996 Storm Damage We hope that you have recovered from the storm and that you are not experiencing any difficulties related to storm damage. As you will recall, following the 1995/1996 Storm, a staff member of the City of Tigard Building Division performed an inspection at the above noted address, to assess storm damage. At that time you were left a notice regarding the need for a permit to cover the necessary repairs. Our records indicate that a Building Permit has not been obtained for the repair. Permits and inspections required by the Tigard Municipal Code are an important part of your repair project. Permits help to ensure that work is done in compliance with minimum code requirements. Inspections are intended to protect the occupants of buildings and building owners. If the work has already been done, we can still inspect it for compliance with the code. ALL FEES WILL BE WAIVED FOR BUILDING PERMITS TO REPAIR STORM DAMAGE. Enclosed are the necessary permit applications along with supplemental information/instructions. Please submit, in person, the necessary application materials to DEVELOPMENT SERVICES, 13125 SW Hall Blvd. Or, if you have questions regarding the permit process, contact DEVELOPMENT SERVICES at 639 -4171 ext. 304. Thank You, • Till Aldrich, Customer Service Manager Development Services 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772