9655 SW NORTH DAKOTA STREET owl
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CITY OF TIGARD BUILDING INSPECTION NOTICE �\
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Inspection Line (Rec•O-Phone). 639-4175 Business Phone: 639-4171 ,
Inspection:
Footing Susp. Ceiling S'prink. Rou 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 / 1
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach. i
Underflr. Insul. Shear Wall Gyp. Bd. �neCt.
Date Requested: 7 �n Time:9
_ 2 PM .�
Address: ..S.1;
L4 �� �� Permit #A1`--"'z7,�,
THE FOLLOWING CORRECTIONS ARE REQUIRED: j
i
�- a s
Inspector: _ Date: 'IiA
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
�� lC _Call For Reinsp.
IlAE-FES F='CRMIT
CITY CC F T I CARD DATE
IT kk. . . . . . . :Ll
ST';C�-
A"F F: ISCiUEL1: �:::lc?/9 ,
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigsrd,Oregon 97223.6199 (503)639.4171 f-'AFRCEL.: 1 S 1351:A-1710307
`51JE ADDFRE S)S. . . . 1T9(; J 51,4 N RTI-i I'(aKOTA ST
SUBDIVISION. . . . : TAM�12yO oFFOVe-C-OR ZONING:
31-00J,. . . . . . . . . . I-OT. . . . . . . . . . . . . .
Remarks: STORM DAMAGE REPAIR TO ROOF SHEATHING, ETC
----------------------------------------------------- BUILDING -------------------------------------------------------------
RLiSSUE: STORIES.......: 0 FLOOR AREAS--------- BASEMENT.,, 0 sf REDUIRED SETBACKS---- REOLIRED-------------
CLASS OF WORK.:REP HEIGHT........: 0 FIRST....: 0 if GARAGE...... 0 sf LEFT..........: 0 SMOKE DETECTRS:
TYPE OF USE...:DUP FLOOR LOAD....: 0 SECOND...: 0 sf FRONT........, : 0 PARKING SPACES: 0
TYPE OF CONST.:5-IHR DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.-.B3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE.,f: 0 REAR..........: 0
---- PLUMBING -----------------------------------------------------------------
SINKS.......... 0 WATER C_OSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 'ILWER LIN*. ft: 0 9F RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS,..: 0 GARBArE DISP..: 0 ;CATER HEATERS. : 0 WATER LINE ft: 0 BCVFLW PREVNTR: 0 GREASE TRAPS..: 0 ..�
OTHER FIXIURES: 0
--------------—----------------------------------------------- MECHAN -- _ - ---------- ---- --- -- --------
FUEL TYPES------------ FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 ANS.....: 0 CLOTHES DRYERS: 0
............- .
FURN )=1009 ..: 0 UNIT HEATERS.. : 0 Hadu5.........: 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: P GF5 OU",.ETS...: 0
- ---
------------------------ -.... --- -- ---- - --- [I FrTF'r�: - - -- --- -- -- - --
--RESI9ENTIAL UNIT-•-- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- BRANCH CIRCI'IT_.--- - --M15(ELLANEOIIS---- --ADD'L IN%ECTIONS--
1000 SF OR LESS: 0 0 - 200 alp..: 0 0 - 12A0 alp..: 0 W/SVC OR FDR..: 0 Pi MP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMIMANFTHM/SNCRFDR: 0 601 - 100r&Aaam 0 601+er6se1000 v: ® EA ADDL BA CIR: 0 �IGNRLiPANEI...: 0 IN PLANT......: 0
p..: P
p.: p IINOR LIiBEL -10: 0
1000+ am)/Volt,: Gi ----------------------------------- PLAN REVIEW SECTION --------------------------•----•---
Reconnect only.: 0 )-4 RES UNITS..s SVC/FDF+=z::5 A. 600 NOMINAL: CLS AREA/SPC CCC:
- --- -- -- -- -------- --_-------------------- ELECTRICAL - RESTRICTED ENERGY --------------------------------------------------____
A. 13F 3ESIDENIIAL--------------------------- B. COIKRCIAL----------------------------------------------•-----------------------••----- -
AUDIO & STEREO.: VACUUM SYSTEM,.: AUDIO & STEREO.: FIRE ALARM.....: INTCRCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER.........: HVAC........... : LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..,.......: INSTRUMENTHTION: MEDICAL........: OTHR:
HVAC...........: DA1A/TELE COMM.: NURSE G,,.LS....: TOTAL 4 SYSTEMS: 0
Owner: --------- - -- -- - --- Contractor; -___ -__- . ...._- ----__._ _ TOTAL FEE' :l 0.00
LINDA G./TAMARYN ASSOCIATES 9 & M ROOFiNG INC.
52'0 SW UROADWAY ST, 1126A 14314 SW ALLEN 11408
TIGARD OR 97223 BEAVERTON OR 97005
Phone N: 503-624-9689 Phone N: 693-6606
Reg A..: 88095
This permit is issued subject ti the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will he done in accordance with approved plans. This permit will empire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
--------------------------------------------------._...------ PEPUIRED INSPECTION5 ._..._.._ -- ---------- -------- -... _ ----- -...
Misc. Inspection -
Building Final
F'trmitt ee i.1An�A -+trr: �__ — _t- _.._ ISs1.IPd Py'
(�i;11 for inspection 6 39- 4175*
M5T-J6 - 005.S
Residantial Building PermitApplication
lication • '
City of Tigard
13125 SIN Hall Blvd.
Tigard, OR 97223
(503) 631-4171
Jobsite Address: � --
Subdivision: Lot # Office Use OnIY
Contact Date / / Initials i
Valuation: , Result _ �__ •
New Construction Only: (Square Footage) Planck/Rcc #_
Permit # _
House: _ Garage: Reissue of _
Cerner Lot? Y N Flag Lot? Y N Map & TL #
Zone
�i
Owner: . _ G,� `t _ Plat #
hr G(,tla-
-69
fApprovals Required
Address: C
Planning Setbacks Solar
Engineering
Phone: ) f46)1 Other _—
�/c� � t,�G Itl,�s Required
Contractor: /
Address ' �/ 1`'l Subcontractors
Truss Details
other__ --- - —
Phone: (7.� •' ) ���> ' �'g3 -ll �c'�C'' Notes
Contractors License # ` � o/ s t"//e y�, —
attach copy of current Oregon license)
Contact Name:
i
Contact Phone
Subcontractors: Architect/Engineer:
Plumbino: Address
Machanical:
(attach copy of current OR Contractor's License)
Phone:
JOB,DESCRIPTION.
Applicant Signatura- Applicant Phone number
IE.e, c%_rwLtJl, _Y
Received by: Date Received:
N V.9n,,m�n�v0
t
I1
Permit S Account an Amount u
Gesuvpti Amt, Pd. Bal. Otte . ..
Sidg. Permit (BUILD) . o
Plumb. Permit (PLUMB)
' Mach. Permit (MECN)
State Tax (TAX)
Bldg:
Plumb:
Mach:
Pian Check (PLANCK)
Bldg: _--
Plumb:
Mech.
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) _
Residential TIF (TIF-R)
class Transit TIF (TIF-MT)
Ca,;mercies Tlr (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TiF-IS)
Office TIF (TIF-0)
',Nater Quality (WQUAL)
Water Quantity ('NQUAN!T)
Fire Life Safety (FLS)
Frosior Cntrl Permit (ERPRMT)
Erasion PlancklUSA (E.-PLAN) `
,onion Planck/COT (EROSN)
TOTALS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspeclion Lin (Rec O-Phone): 639-4175 Business Phone: 639 4171
Inspection:
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beafn Struct. Plbg. Top Out Elec. Rough-in FINAL: ,
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
i
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �'�' \\� ay Time: AM Iv� J PM
Address: �tliSS `,�
Builder: Permit#: ti
THE FOLLOWING CORRECTIONS ARE REQUIRED:
\ ael )
Inspector: ^����lf� C Date:
APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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City of Tigard, Oregon •
Rapid Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RATING: (Check or-)
Name ' L! Lf' ''�%' _ INSPECTED(Green) ❑
Exterior only
Address: . _ Exterior &Interior
LIMITED ENTRY (YeAow) O
No,of Stories: UNSAFE (Red) O
Basement: Yes ❑ No ❑ Unknown ❑ --
INSPECTOR:
Primary Occupancy: Dwelling ❑ Inspector ID _
Affiliation
Other Residential U Commercial ❑ Office ❑ — -
Industrial ❑ Public.Assembly G School❑ INSPECTION DATE:
Government ❑ Emer.Serv. ❑ Hospital ❑ Mo/day/year
Other Time — am; pm
Instructions: Review structure for the conditions listed below. A "yes" answer to 1,Z3,or 5 is grounds for
posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY. A "yes" answer to 4
r 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 Morr.Review
Needed
1. Collapse,pa-;.yl cc�l!•psc,or building off foundation ❑ ❑ ❑
2- Building or story ,noticeably leaning ❑ ❑ U
3. Severe racking of��zll,obvious severe damage and distress ❑ ❑ ❑
4. Chimney,parapet or other falling hazard ❑ U 0
S. Severe ground or slope movement present ❑ ❑ ❑
6. Other hazard present: ❑ ❑ ❑
Recommendations:
❑ No further action required
❑ Detailed Evaluation required(circle one) Structural Geotechnical Other
❑ Barricades neededin the following areas:
❑ Other:
Posted at this Assessment: Occupants Notified to Vacate Temp Housing Req.
❑Yes U o ❑Yes ❑ No U,es--- Ll_No ❑ 7
Comments: L. 17
I ted Damage C1 0% O 25% O 50% ❑ 100% - -_--
OFFICE USE
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