15840 SW ROYALTY PARKWAY ADDRESS:
i:Arectirds\microfIm\tarr.jets\bt-nlding.doc
CITY OF TIGARD BUILCING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 6394171
Footing Rain Drain Cover/Sorvice FINAL:
Foundation Water Line Caiili+g -Plumb.
Post/Beam Mach. Shear/Sheath F,aming -Mach.
Plbg.Und/Flr/Slab Plbg. %p Out Invulation -Elect.
Post/Beam 31ruct. Mech Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �a A.M. P.M. I_. Entry:
Address:
Tenant: Ste: MST:
BUP:
Con/ vim. mz== -. MEC:
PLM:
ELC:
THE FOLLOWING Cul'iRECTIONS ARE REQUIRED: ELR: _
_�'.�,�,�.� •.:4 .,,-tom- __ `�
In�spec : Date: -• /.3"
'APPROVED DISAPPROVED/CALL FOR REIN 3P. CF CO
L—
CITY OF TIGARD " BJILDINGtPERMI'TPfR 111 T #. . . . . . . : BUP9& 046'a
1
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/112/96
13125 SW Hall Blvd,Tigard,Oregon 97223*8199 (503)639-4171
PARC.L- L: 2S 11 0CD-02800
SITE ADDRESS. . . 155840 SW ROYALTY PKWY
SUBDIVISION. . . . ZONING:
BLOCK. . . . . . . . . . 1_(7..1... . . . . . . . . . . . .
REISSUE: I-"[-O('.'jR AREAS— EXTERIOR WALL CONSTRUCTION
CLASS OF WORK. :ALT FIRST. . . . : 0 s N: 5: E: W:
TYPE OF USE. . . :5 F DECLINE. . . : 0 s; r PROTECT
TYPE OF CONST. :5N 0 s N- S: E: W
0C'CUPANCY GIRP-1. .Al 101,A L III S f ROOF CONST: FIRE:` RET? :
OCLUPANC'Y LOAD. 0 BASEMENT. : III s AREA SEP. RATED:
STOR. : 0 HT: 0 'Ft GARAC.7E, — : 0 F.f OCCU SLID. RATED.
BumT? - ME7.7?: REOD SE-rBAu,,'s--- REQU I RED-----------
FLOOR LOAD. . . . : III ps-F I-A-1-FT: 0 ft RGHT: 0 ft FIR SpKL: SMOK DET.
DWELLING UNITS: 0 FPNT: 0 ft REAR: 0 ft FIR ALPM: HNDICP ACC:
B E 1)R lyl":3 0 BATHS- III
.11YIP SURI'ACE: 0 PRO CORR- IDAIRIJ I NG-
VALUE. ,C
-J 00
Remarks : Re-roof & new decking
Owner-: FEES
MAGDALENA KROO type alnol-tnt ID y (J,.At e 1--ecpt
15B40 SW ROYALTY PKWY P R m*'r s W'8. 50 CJS OB/09/96 KING CITE'
` PCT $ 1. 93 CJS 1118/09/96 KING CIT"r'
KING CITY OR 9*7224
PtIOT)L- #. 503-.639-3766
OWNER
Ph-.ane 40. 43 TOTAL.
Req
REQUIRED INSPECTIONS
This pernit is issued subject to the regulations contained in the Fr-arninq I n-,1.)
ligard Municipal Code, State of Ore. Specialty Codes and all other Fin,-.al Inspection
applicable laws. All work will be done in accordance with
approver' plans. This pervit will expire if work is not started
within 180 days of issuance, or if work is suspended for o —---------
than IR days.
.............
P e t,In i t t e P S i q n aA t i.i t-e �t L
........................................
I s;s f.i e ci- By
Ca I I t v v- inspection 639--4175
""— "MAR-05-'00 MON 00:40 ID: FAX NO: 4172 P02 — ---
Plan Cneck v A,
CITY OF TIGARD Residential Building Permit Application Recd By _.P IJAI
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd. �L__
TIGARD, OR 97223 Single Family Detached or Attached Date to P E,, ,._.._
(503) 639.4171 Date to DST _
Print Of T e Permit#
yp Galled, r~,
Incomplete or illegible applications will not be accepted
( Name of Sub Ivision Lot 0 Name
Job I Architect Mailing Address
)Address e Addres ,� �1 _
e '
Ciry/State Zip
Na Phone
" Nome
Owner 8111 Addres
City/State L .Zip Pho�"` _ - , Engineer Mailing Add esa
Namev � Y G City/State Zip Phone
General i 0j f1!_'t- Describe work new O addition O alteration repair O y�
Contractor I Mailing Address 1 to De Cone: L
f
Additional Description of Wot:,1
ritylState Zip Phone
Oregon Const.Cont,boar!LIc.0 Exp.Date C __
Attach Copy or Project
Current COT Business Tax gr Metro 0 Exp.Date valuation T t I�IC�
Licenses - NEWCONSTRUCTION ONLY: _
_
Mechanical Sq.Ft. House. Sq.Ft.Garage: ---�1
Sub- Mailing Address
Contractor Corner Lot Yes No Flag Lot Yes No
City/State Zip Phone - (check one) check one)
Restricted Audio/Stereo Burg'ar
I Oregon Const.Cont,Board Lio,a Exp.Date Energy System Alarm
Attach Copy or
Current COT Business Tax or Metro a Exp.Date Installation Garage Door HVAC
Licenses Opener Systems
Name (check all that Other:
Plumbing apply)
Sub Mailing Address VIAII the electrical subcontractor wire for all Yes No
Contractor restricted energy installations?
City/State Zip Phone
Has the Subdivision Plat recorded? NIA Yes No
Oregon Const ContBoard Lic.$ Exp Date Reissue of MST# Solar Compliance
Attach Copy of Calculation Attache
Current Plumbing LIC,N Exp Date I hereby acknowledge that I have read this application,that theme
Licenses information given Is correct,that I am the owner or authorized agent of
COT Business Tax or Metro>e Exp.Date the owner,and that plans submitted are in compliance with Oregon
state laws. _
�— oma Signature of Owner/Agent ; Date
Electrical Contact Person Name Phone
Sub_ Mailing Address
Contractor FOR OFFICE USE ONLY;
citylstate tip Phone Plat a Map/TL#
Oregon Const,Cont.Board Lief! Exp, Date
Attach Copy of Setbacks Zone: Soler:
Current Electrical Lie.tY Erp.Date
Licenses
COT Business Tax or Metro 0 Fx;.1521. EngineeringApproval; Planning Approval: TIF
IAN�11wH�ww A-
MAR-05-'00 MGN 00:41 ID: FAX N0: 417 PO---, - �••�
Permit Acc�ynt Des�r`il? iQQ ��n Asrd, :
MSl . Permit (BUILD) _ }
Plumb. Permit (PLUMB)
Mech Permit (MECH)
ELC/FI_R Permit (FLPRMT)
State Tax (TAX) l • g_� 1 9 3
Bldg:
Plumb-
Mech:
ELC/LLR:
Calan Check
MST, (BUPPLN)
Plumb: (PLMPLN)
Mech. (MECPI N)
CDC Reviaw (LANDUS)
Sewer Connecti«n (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Ch:3rge (PKSCC)
Residential TIF (TIF-R)
Mass Transit l IF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Frosion Control Permit (E RPRMT)
Erosion Planck/USA (ERPLAN)
Erosion PlanckJCOT (EROSN)
Fire Life Safety (FLS)
TOTALS: ��(1 , i� Lj6 14?�
i\fists\mst3pp dac ��
Permit#: FRU N
r r
Address: 15820 sw 1�'.oyclt'Q
Z� Issued by: -, Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Liv, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
k V 1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for s^'e
before or upon completion.
lJ 3 A. My general contractor is
t_1 (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
f a 3B. I will be my own general contractor.
II1 hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
o ,
(Signature of permit applicant) (Date)
(White copy to issuing agenry permit file,
pink copy to applicant)