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CITY OF T'Ic;ARD Residential Building Permit kpplication Recd By
13125 SW HALL BLVD. New Construction 'kdditions or Alterations Date Recd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. -
V 503-839-4171 Date to DSTa
F 503-684-7297 Perm,t# e . 1 �o
b Y Print or Type Called'AAv4iA io dju VGl
A . �,t Incomplete or illegible applications will not be accepted hvn�� ' J a (
� Y # "j0 ,�[t tt � f o 1�
Name of Project / - - Name - -
Job � 1
Address Site Address Archil'-.;t Mailing Address --
- -�
7 l � r City/State Zip Phone
Name
Owner Mailing Addres
-- Name
Engineer
Mailing Address ---- --- -
City/State— ip Phone
General Name-
City/State Zip Ph)rie
Contractor 0 W h e�f- Describe worr, Nbw O Addition 4K Alteration O Repeir
Mailing Address lobe done:,j'c , .' i',_ ; 1 14(j( ' + r 'c
Prior to permit Additional Description of Work:
issuance.a copy City/State Zip Phone
of all licenses �� /� w
are required if Oregon Const. Cont. Board Exp. Date - PROJECT l
expired in COT Lic# VALUATION
database
Mechanical Name�— - — NEW CONSTR CTION ONLY: �-
Sub- �JI Sq. Ft. House: -- Sq.. Ft. Oar--9e re-, nr._r
Contractor Mailing Address
Prior to permit I Corner Lot YES NO Flag Lot YESNO
issuance,a copy CitylSta'e -Zip_ Phona (check one) (check one)
or all licenses Restricted — Audio/Stereo Burglar
are required if Oregon Const Gont Board - Exp. Date Energy System Alarm
expired in COT Lic# —
_ database _—� Installation Garage Door t]VAC
Plumbing Name -- Opena, — �— Systems
Sub-- (check all that Other:
Contractor Mailing Address apply)
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/State--~ Zip Phone--�- Has the Subdivision Plat recorded? NIA YES NO
issuance,a copy
of all licenses are Oregon Const Cont. Board
Exp. Uate
required If Lic# Reissue of MST* Solar Compliance
expired n COT _ (Calculation attached) _
databa-e Plumbing Lic.# - - Exp Date I hearby acknowledge that I have read this application,that the 1
information given is correct, that I am'he owner or authorized
---- --- agent of the owner, and that plans submitte,: �rp in compliance
Name _ with Oreon State laws. _
ElectricaS?
nature---�--------------_ __ _�.__
_ nature of Owner/Agent J to
Sub- Mailing Address ^--- - �-- �';+- --.. i) < C L-�L 7
Contractor Contact Person Name , Phone#
City/State - Zip _ Phone--- ` J
Prior to permit FOR OFFICE 'JSE ONLY:
,suance, a copy _ _ Plat#: t -- - Map/Tt.#:
of all licenses are Oregon Const.Cont. Board Exp Date , Ir i k, (,-&, /0d
requ6ed if Lic# 1�
S t ck Zor��: i Solar:
expired in COT
database Electrical Lic # Exp Date -
Engineering Approval: Plaming Approval: TIF:
1
I SFREM DOC (DST) 4197
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CITY GF TIGARD hIA TF-R F'#.. ..
DEVELOPMENT SERV!C ES D1 TET #IJED: 1. 4/99 - 1F�
DATE ISF,IJFD: Q�1. /04/'x'3
13125 SW Hail Blvd., Tigard,OR 97223(503)639.4171
PARCEL: i'S101BC--00400
SITE ADDRESS. . . : 1x'330 SW KNCII-l- DP
SUBDIVISION. . . . :KNOL.L ACRES ZONING- R--4. 5
FLOCK. . . . . . . . . . LC]"F. . . ., . . „ . . . . . 1,- 1 JURISDICTION: TTI,
Remarks: COVER DECK AND CARPORT WILL NEED SPECIAL INSPECTOR TO INSPECT THE WELDS ON THE PIPE
---------------------------------.--------------------------_--- BUILDING ----------------- ---------------------------------------
REISSUE:
----------------- ----REISSUE: STORIES.......: 2 FLOOR AREAS---------- BACEMENT...: 0 sf REQUIRED SFTBACKS---- REQUIRED-----------
CLASS OF WORK.:OTR HEIGHT.,....... 20 FIRST...,: 0 sf GARAGE.....: 0 sf LEFT.......... 0 SMOKE DETECTRS:
TYPE OF USE...-SF FLOOR LOAD....: 60 SECOND...: 0 sF FRONT.........: 0 PARKING SPACES: 0
TYPE OF CONST. :SN DWELLING :IN?TS: 0 FINBSMENT: 0 sf RIGHT.........s 0
DCCUPANCv GRP.-R3 RNN: 0 BATH: 0 TOTAL------: 0 sf VALUE..$: 6006 REAR.........,: 0
--------------------------------------------------------------- PLUMBING -----------------------------------------------------------------
SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LM gTORIES.... : 0 DISHWASHERS...: 0 FLMR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS., : 0
TUB/'HOVI`RS...: 0 GE'RBAGF DISP..: '3 WATER H"ATERS.: 0 WATER L:NE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS. : 0
OTHER FIXTURES: 0
----------------------------------- ---------------- .._..------- MECHANICAL- --------------------------------------------------.--------- ---
FUEL TYPES----------- FURN f ION ,.: 0 BOIL/CMP � 3HP: 0 VENT FENS.....: 0 CLOTHES DRYERS: 0
FURN )=1ON 0 UNIT HrrJERS..- 0 HOODS.........; 0 OTHER UNITS...: 0
MAX INF.: 0 BTU FLOOR FURNACES: 0 VENT;.......... 0 WOODSTOVES....s 0 GAS OUTLETS...: 0
--------------------..---------------- --------- -------------- ELECTRICAL ---- - _ - ---- ---- ------------- -- --
M --RESIDENTIAL UNIT--- ---SERVICE/FEEDER--- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCI,ITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS-•
1000 SF OR LESS: 0 0 200 asp. • o 0 - 200. amp..: 0 W/CVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: G
CA ADD'L 5O0SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PEC HOUR......:
'IMITED ENERGY.: 0 401 - 600 amp., : 0 401 - 600 amp..: 0 EA ADDL BR CIP: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF NM/SVC!FDR: 0 601 - RZZ amp. : 0 601+amps-1000 Y: 0 MINOR LABEL -10: 0
!NO+ &np'volt, : 0 ----------------------------------- PLAN REVIEW SECTION -----------------------------------
P.econnect only,: 0 )=4 RES UNITS..: SVC/FDR)-225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
---------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ----------------------------------------------------
A. SF RESIDENTIAL----------- ---- B. ['OMMERCIAL--------..----------------------- -------------------------------------
AUDIO 151L,'EO.: VACUUM C-Y5TFM..: AUDIO k STEREO.: FIRE ALARM.....: INTERCOMiPAGING: OUTDOOR LNDSC LT:
AIIRGLAR ALAPM..: OTH: BOILEF HVAC,..........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL;
bfrhrrGE OPENEn,. . CLOCK. ........; INSTRUMENTATION: MEDICAL........: OTHR: :.
HVAC...........: DATAiItLE COMM.: NURSE CALL.. TOTAL 0 SYSTEMS: C
nwner: - -- _____.___.------------------Contractor: ------------------------------ Tf?'AL FEES:1 168.76
DMITRIY SAVENKOV JOHN MURPHY This permit i, subject to the regulations contained in the
12330 SW KNOLL DR 10175 SW 15TH Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 BEAVERTON OR 97001 other applicable IRws. All work will be done in accordance
with approved plass. This permit will expire if work iF
r'hone EE: 624-5097 Phone 0: not started within 180 days of issuancP, or if the work is
Reg 4..: suspended for more than 180 days. ATTENTION: Oregon law
------------------- ----------------------------------------- --- requires you to follow rules adopted by the Oregon Util:'
Notification Center. Those rules are set fo-th in OAR 952-001-0010 through DAR 952-001-0080. You may obtain copies of these rules ar-
direct geestiors to UK by calling (503)246-1987.
-- _—-------------------—--------------------____..___ REQUIRED INSPFCTIONS --- - ----------------------------------------.-'"-
Erosion Control Building Final
Footing Insp _ -----
Framing Insp --
;hear Wall Insp -----
Rain drain Insp
L -
T s�.�.ed By: ., Flermittee Sign;-Rtr.:r'p &L-C
f +-++..+..+..+..++++r+-, + +-+ r r +. r. r + 4 f+.+. f f., + f.4-1+++ r'..+i r r f r i r- r
Ca. 13. 6 9--41.75 by 7:0 p, m. for an inspection needed t:t•ie next tarAs, trreSS C' .,
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
� ` BLIP _�—
__ Date Requested -AM PM _ BLD —
Location ,--�. -�) .5 C1 :' .�1.� 11�' L.� _ Suite —_ MEG
Contact Person Ph _ PLM _
Contr r Ph SWR
U Tenan,/ ELC
all ELR
Footing Access.
roundation FPS
Ftg Drain - SGN
Crawl Drain Inspection Notes: �� �,,,� j ------- ----
Slab --- - ------- -L.r //U -- SIT —�--
Post& Beam
Ext Sheath/Shear
I /Shear
ami - - ---- -- --------
on'
---on
Drywall Nailing
Firewall
Fire Sprinkler - ----__ _
Fire Alarm
Susp'd Ceiling - —---------------- - — —
Roof
�.
P/t5 PAf2T FAIL —- --- ----- —--
GING _
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART_ FAIL
MECHANICAL.
Post& Hearn
Rough In J
Gas Line -
Smoke Clampers
Final - -- —_ - --------
PASS PART FAIL
ELECTRICAL - - ---- — - -- -- --
Service
Rough In
UG/Slab ---- - - --- --
Low Voltage
Fire Alarm ---- --- - -- - __ _ ----- ---�-
Finel
PASS PART FAIL — _-__-- ---_--- -.— ---- -- -- -SITE
Backfill/Grading ' - —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$_ required before next inspection. Pray at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE: -- ( ]Unable to inspect no access
ADA j �Ip
Approach/Sidewalk Date / � I r
@CtOE � Ext
Other �l --
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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