13200 SW VILLAGE GLENN DRIVE-1 ■ ���v
� ;uAt� � GIENn) i.RIVF
ADDRESS:
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;:\records\microflm\targotstuilding.doc
I
1
CITY OF TIGARD
>
DEVELOPMENT SERVICES '
EN13INEE:RING PERMIT
(1E 2MIT #. . . . . . . s ENG97•-OO56
131,,5 SW Nall Blvd., Tigard,OR 97223 (.503)639.4171 FSR I M. PERM IT #. . : ENG9-1 OOZE.
DATE ISSUED: 10/08/97
T-fr: ADDRESS. . . s I. 3.00 SW V I I.A.41U I il_ENN DR PARCEL. 1 2S 1 O2CA._(10'-_:4a3
iJ3D I V l S I ON. . . . : V I LLOUF GLENN 7..ON I NO s R--4. 5
q_OCK. . . . . . . . . . : L.04. . . . . . . . . . . . . 1023 JL)R15L)TCT ION: TIG
FRMIT TYPE. . s SOP PUBLIC IMPRV s QUANT. (LIN FT) VALUE
AGREE=MENT DATE: J GRAD/EROS -***- $
iS URANCE EXPIRATION—— 91`REE T $
PERFORMANCE: I � SAN 5F"W $
MA.'"T'ENPNCE: / ! 9'rM SFW $
PATHWAYS " F
'TOTAL. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .
pmr�r14 : STREET AN;N6, TO TAP ($4 k,:STING MAINLINE SANi1ARY SEWER LIFE iM TO
ASTALL A (BUILDING) SIDE 5ANITARi ",C*.R SERUCE LATERAL.
e►^m i t t pe _...... ._ --..__..-...._._..._ _..__ FEES
lIL"lAN to MAT'TO type Z4MC'.Ilnt by H_Ate recpt
13200 S. W. VILLAUE GLEN DRIVE OPEN $ 24. 00 JSD 1O/08/97 97--e9987`,
IIGARD GR 97223 HONLI $ 6O0. 00 JSD 10/O8/97 97--299875
''hone #.-
624. 00
,�ngiri�er.. s
/I
REQUIRED I NSPEC r 1 mis - _... _...
'ermittep/Agent /;i gnatt_r� - �3rfaF?lYl SEWER--
/��,� + �G 1 hl. H� A C. B. CRH ;..INE' R RRAL;i
PIPE, 1_N R ORD SURGRADE
- BCKF(_L. & CMPC;'T BASE. ROCJ<
AIR a IV TESTL_EVE�L (]OURSE.
City of Tinlwd, OreyoriWEi.ARING COURSE=
�?1r±:5 �. W. H1 ]. Eilvt�, - - SAN. SE4II'.R- _ 'TRAFF & WED COIN
r I GARD, Oregon 9721" M. H. R- C. O. MCINUMENTAT I ON
'-'hone #: 639--41.71 CII-'C L,►V A GRD STREETI-IGHTING
Hr'KF=I_.I_. & CrIPUT WAi._K/APRON;RAMP
AIR & 'TV TF_aT
i1; I NSPEC 1 10N. r0N'TAC;T:
L.ethr. Thrim s #639-4171 (office?) _-REPR' L;/ADJ, S-- CONTOURS
#780•-2647 (mobile) DRA IMAGE
- - PA THWAYS--_ EROSION CNTI...
,PE.CIAL CONDITIONS:
M
MIL
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97-040'7
LUCIAN B MATIA
137.00 SW VILLAGE GLL" DP
05/28/9U
Action Dfecription Req/ Schd/ End/ Action Not.eo Diop By Update Upd
Cede Sent ']one Done Date By
------- ------------------------------ - --- -------- ------------ - ------"____-.
PL14AO03 Application received / / / / 10/01/97 PASS DRA 10/08/97 JD
PL14A005 Create Permit / / / / 10/08/97 PADS JSD 1.0/08/97 JD
PIMA040 (F) Ready to imeue / / / / 10/U8/97 PASS JSD 10/08/97 JD
PIMA050 (P) Iaaue permit / / / / 10/08/97 PASS B 10/08/97 DST
PL,MA705 9uwer Inspection 10/08/97 / / 11/07/98 PASS MH 05/12/98 J+H
< PLMA799 Pinal Inspection / / / / 11/07/98 PASS MS 05/12/98 J•H
PIMA800 Came Finaled / / / / 11/07/98 PASS Mn 05/12/98 J*H
CITY OF TIGARD
LUMBING
DEVELOPMENT SERVICES PERMIPT #. . . . PERMIT
. . . : F'LM97-0407
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 10/08/97
PARCEL.: 2SI02CA-00923
SITE ADDRESS. . . : 13200 SW VII-LAGE GLENN DR
SUBDIVISION. . . . : VIL.A.-AGE GLENN ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :0`3 JURISDICTION: TIG
------------------------------------------------------------- ---
CLASS OF WORK. . :AL.T GARBAGE DISPOSALS. : 0 MOB IL.E HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANC Y GRP. . : R3 FI_0OR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------------- L.nUNDRY TRAYS. . . . . : 0 SF RA I N DRA I NS. . . . - : 0
SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
L-AVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER L.INE (ft ) . . . : 100
WATER CLOSETS. : 0 WATER LINE ( ft ) . . . : 171
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Lay second sewer line hook—o-ip for resicleTlce , no additional sewer
connection permit reqoi.red.
Owner: ---------------------------------------------------------- FEES
I_UCIAN B MATIA type Amoi-int by date recpt
13200 S. W. VILLAGE GLEN DRIVE PRMT $ 30. 00 B 10/08/97 97-299893
TIGARD OR 97223 5PCT $ 1. 50 B 10/08/97 97--299893
Phone #: 9ES-1576
Contractor--------------------------------
OWNER
-----------------------------------------
Phone #: $ 31. 50 TOTAL.
Pe(A 999999
REDUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all othrr Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This vr.,sit will expire if stork is not started
within 180 days of issuanr_�, or, if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to fellow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-MI-0010 through OAR W. -W14W. You may
obtain copies of these rules or direct questions to RINC by calling
(503)246-198'.
1 S s i'l e d By Permittee SignitlArc :_
'0000,
++++++++++++ .................I................4-+4++++++++-4......................
Call 639-4175 by 7:00 p. m. for an inspection needed the next bl.isiness day
.............4.........4•................1-++4................................
Re. '
d 9y
CITY OF TIGARD Plumbing ApplicationDate Recd
13125 SW HALL BLVD. Commercial and Residentia; Date to P E.
TIGARD, OR 97223 Dace it US
T 8
(503) 639-4171
Print or Type Related SWR0
Incomplete or illegible applications will not be accepted Called-,�i� "
Name of DevelopmenuProjed r - QTY PRICE AMT
Job CrC-�A� �� �r�H���
Fa
ES (Indlvldual)
Address `'beet Address pc� sorts --- s 00
VPK t r�lt�r.7 !�i'Blddg 0� CIState ZrP ub/Shower Comb. 3 00
Tl6Only 9 00
- — Name I I J I Water Closet 9.00
Suite Dishwasher 9.00
Owner Marling Address - � - - 9.00
r. Garbage Disposal _
City/Stale Zip Phone Washing Machine
-- Floor Drain2" 900
Name 3
-- 9.00 -�
Suite IIS" 9.00
Occupant Marling Address _�4"---- 900
Water Heater O conversion O like kind 9 00
ICitylState ZipPhone Laundr-Room Tray 9.00
---- Unnal 9.00
`- Name J 9.00
Other Fixtures(Specify)
Contractor Marling Address
Suite _ - 900
9.00
(Prior to Issuance City/State Zip Phor,e -- - 9.00
applicant must _ — 9.00
provide 311 Oregon Const.Cont.Board Lica Exp.Date — 9 00
contractors _
license Plumbing Lic.! Exp.Date -Sewer-tst tU0" 30.00
Information if Sewer-each additional 100' _ 25,00
expired — 31.00
in COT COT in
Busess Tax or Metro ll Exp Dale Water Service 1st 1Q0'
database). _______ Water Service-each additional 200 _ —
Name Slor m&Rain Drain- 1 st 100' 30 JO
Stone&Nam Drain-each additional 100' 0
Architect _
Mailing Address Swte Mobile Home Space 25 00
j Or -
Commerdal Back Flow Prevention Device or Anti- 25.00
C11i /91ate T.ip Phone Pollution Device
Engineer ------ -- 15.00
_ Pesidential 9 ckflow Prevention Device'
Describe worts New O Addition Q Alteration O Repair O Any Trap or Waste Nat Connected to a Fixture 90
to be done: Residential O Non-residential O - g Op
-- Cat tt Basin
P,dditronal description of work -- 40.00
Insp.of Existing Plumbing er111r
Specially Requested Inspections 4000
_ f perlhr_
Existing use of Ram Drain,smgle family NNelling 30.00
budding or property ----_ 9 00
Grease Traps
Proposed use of
TITY TOTAL
building or property — -- t]UAN
Isometric or riser diagram is required 6 Ouarrity Total is >9
Are you capping, moving or rePlac+ng any fixtures? Yes[i No Q
9UEITOTAL
(if yes see back of form) 5% SURCHARGE
I'iereby acknowledge that I have read this application,that the information
jliven is correct.that I am the owner or authorized agent of the owner,and PLAN REVIEW 25%OF�—SUBTOTAL
that pla s submitted are in compllanye with Oregon State Laws
Signature of OwnarlAgent Date Requrred only A tfxturegry later is>9 TOTAL
CXj-Z
._. --
CartCact Person Name Phone *Minimum permit fees$25-5%surcharge,except Residential Backflow
Prevention Device.which is S15�5%surcharge
rsia`oKr�P dos 6191
F LEASE OMPLETE AAPEROPEUA E D PROff-�CI:
Fixtures to be capped, moved or replaced I city
Sink _ —
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
Water Heater _
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
i Uttepreoo�Joc 59,
Page No. 1 CASE HISTORY FOR CASE NO.. MST'97-0373
LUCIAN MATIA
13200 SW VILLAGE C ^'NN DR
05/28/98
Action Description Req/ Schd/ End/ Action Notes
Uiop By Update Upd
Date By
code sent Done Done
------- -------------------- -------- -------- -------- -`
MBTA005 Application received / / / /
09/08/97 RECD GEO 09/09/97 BON
MSTA008 Permit Created / / / /
09/09/97 DONE B 04!03/97 BUN
MSTA010 Check for prel. restrict. / / / / 09/09/97
PASS 8 0909/97 BON
MSTA012 plans routed to plane Examiner / / / / 09/09/97 SENT B 09/09/97 BON
M9TA026 Plane approved by Pln Examiner / / / /
09/10/97 PASS RT 09/10/97 HT2
MSTA030 Revi4wed pl,,uin routed to DSTS / / / / 09/10/97 PASS RT 09/10/97 BT2
MSTA032 DBT Post-Review Cort.pletad / / / /
09/11/97 PASS DRA 09/11/97 DRA
MSTA050 Hold for / / / / 04/03/98 cue final. sent inspection slip HOLD JT 05/12/90 J•H
ken. The newer line on the
plumbing permit has not been inspected.
Owner called in on master but obtained a
separate permit, 110797 Mike S approved
newer. See P11497-0407 (SOP s PLM were
not grovped, fixed 051298.)
MSTA080 (F) Ready to ie•ue 09/11/97 Have owner sign owner liability form, PASS DRA 09/11/97 DRA
issue electrical label over the counter,
ane enter the overage of $62.15 as a
minus amount in the receipt.
MSTA092 (F) Issue combination permit / / / / 09/11/97
PASS B 09/11/97 DST
14STA202 Hold. Release to Issued Status / / / / 05/12/99 New sewer lateral from P11497-0407 wan PASS IMH 05/12/99 J•H
approved 110797. owner called in on MST.
Slip in file. Entered 0E1298,
MOTA704 Sewer Inspection / / / / 11/07/97
PASS TLP 05/12/98 J•H
MSTA705 Footing lnnp 09/22/97 oee foundation notes, approved an noted PASS KS 09/22/97 J•H
M8TA706 Foundation Insp
/ / 09/22/97 Approved as noted: PASS KS C9/22/97 J•H
1. Need initial erosion control
approval.
2. Monolithic footings/foundation.
3. Install anchor bolts size and spacing
an shown.
OK TO POUR AFTER xRobION CONTROL I8
APPROVED.
MSTA707 Slab Inap / / 10/16/97 Slab on grade,insulate total PART Kb 01/07/98 KBS
perimeter. To R- 15 extend minimum of
twenty-four inches.
MBTA717 ptm,'Underf.loor / / / / 10/03/97 call back in tie into sewer PASS MS 10/03/97 MPS
R W, NO
Page tJ". -
CASE HISTORY FOR CASE NO.: MST97-0373
LL.JIAN MATIA
13200 SW VILLAGE GLENN DR
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Sent Done Dome Date By
Cote
MSTA720 Mechanical Insp / / / / 11/25/97 1. Need 3 min. screws at each connecting FAIL. GS 01/07/98 KBS
joint, Thie inspection in for vent fans
and heat ducting, no connecting to
existing, heat supply has been made at
this time return air through existing
house. call for reinspection of mach
roughin with framing.
MSTA720 Mecha•ical Insp J J J /
12/02/97 FAIL. C9 01/07/99 KJ?S
Provide felt behind etude and lower
level. Contact with foundation wall.
Firestop furred wails at ten ft.
horizontal. Main door between existing
and addition, not installed at this
t:iie. Extend save baffles 19-inches
above bottom of truss chord. provide
positive connection between existing
additon at plate/1-straps.
Provide motrl flashing at front
subsiding in contact with concrete, also
caulking joints.
Connect heat ducts At lower level to
supply duct.
12/15/97 / / 12/15/97 PASS RC O1/07/9N KBS
MSTA720 Mechanical Insp pA88 MB 11/11!97 J•N
MOTA722 Plumb Top Out / / / / 11/07/97
MSTA723 Electrical Service / / / / 11/25/97 panel not approved for closet FAIL a" 11/25/97 MJR
M1ITA724 Electrical Faugh In / J / /
11/26/97 PASS DRP 12/02/97 J*H
i / 12/15/97 Furr out wall needs fireblock at top and PASS RC 11/15J97 JAM
MSTA725 Framing Insp / /
10-ft intervals, oK to insulate.
MSTA725 Frar.Ar.g Insp 12/15/97 / / 12/16/47 Not ready, cancelled. Note: This in an FAIL RC 12/17/97 J•H
adult foster care home SR3-less than 6.
MSTA725 Framing Insp
/ / / / 12/23/97 APP KS 12/24/97 KBS
MSTA725 Framing Insp
/ / / / 12/02/97 See mechanical iuopection for FAIL KS 05/12/99 J•H
corrections th�s date.
MSTA726 Shear Wall Innp / / / / 10/15/97 No We required. PAPS KS Io/16/97 J'H
Mg-A-1-8 Low Voltage
/ / / / 12/15/97 pArS AAP 12/15/97 J•H
MSTA740 insulation Innp / / / / 12/23/97 4 1- seal around all penetrations floor AI-P KS 12/24/97 KM
/ ceiling
9-2- insulte rim joist,also floor cavity
at ext wall_
j
MR
Page N+,. t CASE HISTORY FOR CASE NO.: MST97-03'13
LUCIAN MATIA
13200 Sh' VILLAGR GLRNN DR
05/28/98
Action Description Req/
8chd/ gnd/ Action Notes Diap By Update Upd
Date BY
coie SentDone Done
...-- -------- ---- --- ---
MRTA745 Gyp Board Lipp
/ / / / 01/07/98 NOTE FRAMING NOT roMPL ffB AT JACUZZI. PASS RS 01/08/99 J•H
PROVIDE ACCESS WATER PROOF GYPSUM AT
FACE OF JACUZZI.
03/02/98 PASS WA 03/03/98 J•H
MSTA755 Rain drain Inep / / / / PASS HRP 03/02/98 E•P
MSTA790 Blactrical Final / / / / 12/15/9.1
03/02/QB PASS BRP 05/12/98 J•H
MSTA790 electrical Firial / / / / pp„g RS 03/04/98 J•li
MSTA795 Mechanical Final / / / / 03/04/98
MSTA797 Plumb Final
/ / / / 03/02/98 1. Rain drains approved. FAIL WA 03/03/98 J•H
2. Lav drain for downatwirs lave can't
have offset trap arm in vertical
ponition.
MSTA797 "uml) Final. / �' 03/04/99 Items or inspection report dated 030898 PASS 'NA 03/04/98 J•H
have been corrected.
MSTA199 Building Final / / 03/04/98 I. Slope finish grade away from PA£_ R9 03/04/98 J•li
structures at side of rear lam weather
permits).
2. Plumbing final approved 3-4-98.
3. structure has working amok*
detectors.
M'TA970 Case Finaled / / / /
05/28/98 05/28/99 .;T
CITY OF TIGARD MASTER IDERMIT
PERMIT #. . . . . . . . MST97-0373
�. DEVELOPMENT SERVICES DATE ISSUED: 09/ 11/97
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171
FIARCEL: `S 1.02CA.-00'323,
SITE ADDRESS. . . : 1300 SW V 11__LAGE GLENN DR
SUBDIVISION. . . . :VIL_LAGE GLENN 7()N I NG: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : JURISDICTION: TIG
Remarks: Single-family addition PATH I
--------------------------------- BUILDING -- --------------------------_—_------- --------__—_-----
REISS(E: STORIES.......: 2 t-L00R AREAS---------- BASEMENT...: 364 sf REQUIRED SETBACKS---- RE(XUIRED--------- ---
CLASS OF WORK.:ADD HEIGHT........: 21 FIRST....: 409 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 0 PARKING SWACES: 0
TYPE OF L'I)HST.:5N DWELLING UNITS: ! FINBSMENT: 0 sf RIGHT.........: 5
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL-----•--: 409 sf VALUE..$: 51714 REAR..........: 30
----------•----------•---------------------------------------•-- PLUMBING -------------------------------------------------------------------
SINKE. 0 WATER CLOSETS.: 3 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS,........: 0
LAVATORIES....: 3 D1S1*ASFERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: I GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
---- MECHANICAL -------------------------------------------------
FUEL
-----------------------------•-------FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMP l 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 0
GAS FURN )=109K ..: 0 UNIT HEATERS..: 0 HOODS........... 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 7 WOODSTOVES....: 0 6% OUTLETS...: 0
-------- ELECTRICRI- -------------------------------------------------------------
—RESIDENTIAL UNIT---- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS--- -•-MD'L INSPECTIONS--
1080 SF OR LESS: I P, 200 amp..: 0 0 - 230 amp..: 0 W/SVC OR FDR..: 0 PUMP/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
LIMITED ENERGY.: 0 401 - 600 amp,.: 0 401 - 600 amp..: 0 EP ADDL BA CIR: 0 S1b71AL/PANEL...: 0 IN PLANT......: 0
MAW HM/SVC/FDR: 0 681 - 1008 amp.: 0 601+amps-1000 v: 0 MiNOR LABEL -10: 0
1000+ amp/volt.: 0 ------------------------------------ 14AN REVIEW SECTION -----------------------------..
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
----- ELECIA CAL - RESTRICTED ENER„Y ---------------------------------------.-___--____
A. SF RESIDENTIAL----------------------- B. COMMERCIAL-------------------------------------------- ------------------------------
AUDIO I STEREO,: VACUUM SYSTEM-: AUDIO I STEREO.: FIRE ALARM..... : INTERCOM/PAGING: OUTDOOR LNDSC LI:
BURGLAR ALARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PKJECTIVE SIGN:
CARA% OPER..: CUP........... IN5TRLK:T'niNn- MEDICAL......... OTHR: .1 1.
HVAC,. .,......: DATA/TELE COMM.: NURSE CALLS....: TOTAL A SYSTEMS: 0
Owner: --- --- --- ------ ------- ----Contractor: ---- ----- -------- TOTAL. FEES:t 800.63
LUCIFY'i B MAT1A OWNER This permit is subject to the regulations contained in the
13200 SW VILLAGE GLENN DR Tigard Municipal Code, State of Ore. Specialty Codes and ali
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone t: %8-1576 Phone t: not started witnin 180 days of issuance, or if the work is
Reg C.: Q( t suspended for more than 180 days. ATTENTION: Oregon law
------------------------------------------------------ _ - requi-es you to follow rules adopted bi the Oregon Utility
Notification Center. Those rules are set forth in OAR 952401-0010 through OAR 952-001-00R0. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
---- -- -------------- ----- REOUIRED IMSFCTIONS -- ------------- -- ------ --- -------- ---...
Footing Insp Electrical Servi Insulation Insp Plumb Final �_-
Foundation Insp Electrical hough Gyp Board Insp Building Final
PLM/Underfloor Framing Insp Ra-n drain Insp - ——
Mlchanllal Insp Sheer Wall Insp Electrical Final -
Plusb Top Out ow VoltageNA,
Mechanical Final _ _ — 4F
7
2111 ' h__ Permittee Si gnati_ire : ��L-� -
++++i•+++4++++++4 4-+++ >•++++�F•1-+t+4ii++'+4-+�-.+�4i--4-...4+�++i-.+ �+�+'....+t ttt+t+� +t�+t
Call 639-4175 by 6:00 P. M. for, ar, inspection needed the next �_isineSS day
J
Plan Checic 0
:ITY (;F TIGARD Residential Building Permit ApplicatiGn Recd By '-rt-c:'
31 :e; SW HALL BLVD. New Construction Additions or AlterationsDate Pec'd "
1GARD. OR 97223 Single Family Detached or, Attached (Duplex) Date to P E.
503-639-1171 Date to DST
503-684-7297 Permof>r 7T
Print or Type Called q-11 -7
Incomplete or illegible applications will not be accepted
N ma of Project Name
JOt) I Q ( )IG�� Mailing A --
Site Addre Architect 9 ddress
Address ,
Nam
C tyiState Zip Phone
Name
Owner Mailing Address
��'� • �t.r ' v..-�.4s;;f_ Iv/V
Gty,Statt. Zip P�_pporls
Engineer Mailing Address
ob�)?"�7_' y -- /,; '
Name CtyrStale Zip Phone
General i ?(� /�/' /� Descnbe worx New O Addihon O Alt ration O Repair O
Contractor Mailing Address to be done _
Additional Description of Work::
C'tyr5tate Zip Phone r I( `r, (Ch1 �� /XC 170a
Oregon Const.Cont. Board LSC k Ex!). Date 'A1�( { p '
tach Copy of
Current COT Business Tax or Metro 0 Exp, Date PROJECT / 7j`7// G ^
Licimses VALUATION
Name --
Mechanical NEW CONSTRUCTION ONLY:
Sub- Mailing Address Sq. FL House: ? Sq. FL Garage
Contractor Corner Lot YES NO Flag Lot YES NO
Cay/slate Zip Pho a (Check one) (check one)
Oregon Const. Cont. Board L c.# Exp. Date Restricted Audio/Stereo Burglar
Attach Copy of Energy System _ Alarm
Current COT COT Business Tax or Metro M Exp Date Installatlen Garage Door h4 AC
•'1Cen3tl3 Ooener Systems _
Nama (check all that Other-,
Plumbing apply) _
Sub- Mailing Address — Will the electrical subcontractor were for all YES NO
Contractor I
( restricted energy installations?
j C,ty;state ?:p I Phone Has the Subdivision Plat reccrded? N/A I YES NO
Cregon Const. Cont. Board L.c.x Exp. Dace Reissue of MST# Solar Compliance
attach copy of
-- —ulabon Attached) _
Current P!umoing Lic # Exp Cate �Calc-- —
I hearby acknowledge that I have read this application, that the
Licenses information given is correct. !hat I am the owner or authorized
COT Business Tax or Metro x Exp Date agent of the owner, and that plans submitted are in compliance
Name I with Ore on State laws
I 5ignatLre of Owner/AgentI Oatr,
-Jectrical L�� " ""t"
L __ ;_.__ t_v• ,�
Sub- tailing Address ( Contact Person Name Phanq tt
ontractor I l ' .f
lC,tyrStateE p Phone FOR OFFICE USE ONLY: r (" t' (?C'Q .
,tti(
Plat# Map/T #.
Cregon Const. Cont Board L c x Exo Date ° �i, 1 I u'O 7t"' ?
%"ach Copy ofI -
Sgtbl�cks� (� � i c.. � Solar.
Current E ectncat Lc it E.xp. Date
Licenses Engjn ehng Approval: I P'annln .=pprovel: 77F 1/L
COT 3usiness Tax or Metro 4 I Exp. Date I�Jf`
FREMOL.30C tcSn 097
r�js�y7-03� MST. Permit (BUILD) (UBUILIA 2�'1, uv ✓ `�
Plumb Permit (PLUMB) (UP MB)
ru t
Mech. Permit (MECH) (U E H)
ELC/ELR Permit (ELPRMT) ( ELP T) u.
State Tax (TAX}
III
�, 2
BLDG: � {=
PLUMB:
MECH:
ELC/ELR:
Plan Check
MST: /
(BUPPLN) (Ob UPLN) 7,
Plumb: (PLUMB) (U 'U B)
Mech:
(MECPL.N) (UMEPLN)
CDC Review (BUILD) (CDCBLD) (L, wCDC) c��'
,4 Cd
CDC Review (PLN) (CDCPLN) h/A
Sewer Connon (SWUSA) (USWUSA) �-
Reimbur. Distnct ( ) ( )
Sewer Inspection (SWINSP) (LISWINS)
Partes Dev Charge (PKSDC) N/A
Residential TIF (TIF-R) (UTIF-R)
Mass Transit TIF (TIF-MT) (UTIF-M)
Water Quality (WQUAL) (UWQUAL)
Water Quantity (WQUANT) (UWQAN-T)
Erosion 'Control Prmt (ERPRMT) �'UERPMT)
Erosicn Planck/USA (ERPLN) (IJERPLN)
Erosion Planc!,'COT (EROSN) (UEROSN)
Fire Life Safety (FLS) (UFLS) er
� 3
TOTALS:
I SFREMDL.DCC :DST) 697
I
Solar Balance Point Standard Worksheet
Address f f �l �lr .► rat r►. -,�vF� � T�c�a!? �/�
Box A calculations: North-South dimension for the IoL —_ 1 Sox A.
1
This dimension is determined by Finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
Firms, determine which property line is the Norti, lot line. The North lot line is the line
with the smailest angle trom a line drawn east-west and intersecting the northern most
point cf the lot.
46n-..
I��wr
N North-South
Dimension for Lot:
MeasIL-re the distance from the midpoint of the North lot line to the South lot line along
the described line.
feet
* — I
1
N
Box B calculations: Shade point h ight for your residence. Box B:
1 Determine whether measurements wiil be based on the peak or ear of}our Which describes
strurrure. The orientation (Jr r , ridge is also important.
your residence?
la: If the r.)of line runs North-South, measurements will f (cirde one)
bit b?sed ort the peak of the roof. ❑�11
-ON--► 1 A 1 B 1 C
1 b: If tf-e roof line runs cast-West and the ooi pitch is
less than 3112 measurements will :e *asev cr. :fie
ear e.
«n"L-4
1c: If the rcof lire runs East—vest and the roc( pitch ;s
3/12 cr sleeper, measurements will be based 3n the � I
peak. 1-43 10"m
I
I
Box B. continued Box B:
Measure change in efevation from front property line to finished floor elevation. If
the !ot slopes up from the front lot line to the foundation, the Figure is positive. If ft
the lot slopes down from the front lot line to the foundwicin, the figure is negative.
3. Measure disortce from finished floor elevation to the affected peak/eave. + — ft
4. If the roof line runs North-South, deducx three feet. If the roof line runs East.West, ------ It
deduct nothing.
:a. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property lint_, if the lot slopes up from the front to the rear. If the
lot has no ;lope or slopes up from the rear to die front, deduct nothing. ft
6. Tool vre for box B: ft
Box C. Distance to ,he shade reduction line. Box C.
1. Measure the distance from the North property line to the foundation near the ft
affected peak/eave.
2. Measure tore distance from the foundation to the affected peak or eave. + ft
3. Total figure for box. C: It
it is most use"in draw a verod fine in represent the appropriage frgune fund in boot'A'and a horizontal line to represent the
aptxopraste 6igure found in box'C'.The interset7ion of the vertio9 and horizontal Gres dem mines the value fund in boot'O'.TSre value
in box 'O'shm-ld be compared to the value in box'0'; if the value in boat'9'is less than or equal to the value found in bax'O', then
trit bonding is in oompliance wilt: the solar balance code. if you have any quesnons,please contact us at 639.1171,x304 or at the
Commurdty Oeveiopment Country.
W=muM PE814 TIED SHADE POINT WEIGHT (In feet)
oismi ce to North-south lot dimension tin fee0
shade 1004• 95 90 65 80 75 70 65 60 55 50 4S 40
redumon rine
Rnm northern
ane fin feed
70 40 40 40 41 42 43 44
65 38 31r 38 39 40 41 42 43
60 36 36 36 37 . 38 39 40 41 42
55 34 34 34 35 36 37 38 39 40 41
50 32 32 3= 33 34 35 36 37 38 39 40
45 30 30 30 31 32 33 34 35 36 37 38 39
.0 23 ?3 :9 29 30 31 32 33 34 35 36 37 38
35 26 26 26 23 29 30 31 32 33 34 35 3S
.0 24 24 �s 25 '5 '_7 '_3 _9 30 31 32 33 34
21 22 22 23 24 25 2y 27 28 29 30 31 32
.� 20 :0 20 21 2-1 23 24 25 26 27 28 29 30
t5 18 18 18 19 _0 21 2_1 23 24 25 26 27 23
10 16 16 16 17 13 19 =0 21 22 23 24 25 =6
5 14 14 14 15 16 17 18 19 20 21 22 23 24
Box D. Maximum allowed shade point height:
t
ti draawncti+Kra,nbotu�+o
Permit#:
Address:
: ; Issued by: .�� !!_--
Statement: Information Notice to Property owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), require.% residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following stuternent before a builaing permit can be issued. This statement is required
fior residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under DRS 701.010(7),
ne(,(l not submit this statement. This statement will be filed with the permit.
Mill in the appropriate blanks and initial Boxes 1 and 2,and either box 3A or 313:
own, reside in, or will reside in the completed structure.
1 /3 (Q
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
F1
3A. My general contractor is —
(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
Alt B. I will be my own general contractor.
If I 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 anti that I 11a1c read anti tlt►understand the Information
Notice to Pro mrty Owners bout Construction Ilespon"'hilities on the re%vi w Nitre of this forst.
ignature of permit applicant) (Date)
(White copy to issuing agenev permit file,
pink copy to applicant)
, ul�w4lwY:t,Ili��imm ..r, Y '�"wf- •dil�ps.�4a MNYI,.,,Y✓VfIM4„:r•,.�:- d.:.:..�,. .r9:s...
-.. .•�w. rY..e.wtnn ....��a`i�Br�.tlnw'WWNniiihlYWt'
information Notice to Property Owners
About Construction Responsibilities
1, ,F ' 111:! h-if It l tLll t 'R,'t 11.17. Sf.51.
:i l• 1,.111 ti�ai,_. �ilir, ,. .,..ti;� „ItiW.. J _'�I ..,illi. ., ✓' tip�1�. lil.(U.:: uIld 'lit•.'„A
EMPLOYE:P RESPONSIBILITIES:
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(,�!'I`•' tttull, Call If1C f,''I'„I, i t.Ca t 1 j°,"•C'Ctltt-' I) Q., Lri'f
mcr?ihl, "):1i,:lit 111.,J;11Ik itIII Ilio
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0144:R RESPONSIBILITIES AND AREAS OF CONCERN:
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l`IU;trSIll In `:r)IIr II'rfit Ion IfitMirTh Iit',i1(•t:ll„IIT.
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; 'I;ililiiFe Rill 11111C 1"1111,lilies, (lit, or Work Ili-l( tlt,lcl I,t^
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II Y�:II llil~,'t,' ellf(.I ItIC,l litl ill l!"l' 'c111!l' 1�I iillf i 1t.' �
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t•�„�) r1u,t I,r!v1
I ,1
94' - 8 7/8" - --
�L, I��I1
FA F
i NIJ�TE;CONNECT STORM SEWER_T
�)
EXISTING STORM SEWER r � ___-----�" �1Y S C
48'_ 0,
EXISTING20' 0"
"1Z E _STRUCTDRE �-� L d •5 , I'14� L.
c ._. __ _
26` 8 7/8
SW ASH - Gl °_.
NFW ADDITION
° :r k0 /T
I23'- 0" 21' S 3/8 I sIAD E
4„ CbNC,
OR IVEWA'f 1
I�� � 1�� C�r1 Sylr�'
1'�''OO �R V11,1 hGE t;JAN
N
SITE PLAN
- --—!
i
— - 94' - 8 '1/8"
DNNECT STORM SEWER J t ��
NG STORM SEWER I
48' - 0" _-
-
EXISTING LP•11 - '
�STR�CTUREJ �-� l f o -t�•`� I I'I�� L•
7/811
4, _. G1,
I
Liz 6p
NEW ADDITION
I
23'- 0" 2l' - 5 Jib S r1oE
�F
C"c _ 1 S
[PIVEWAY
- F- - -
r I��J - - - ( dry
13200 Sl VILLAGE GLENN
N
SITE PLA
1 P P=20 r _Ov v
94' - 8 7/81, --- ---- - -- --
- � I J.
Z'r, �/� � L—�//� r i>r- COY✓'41rc..-/'_� �1.� >>�
+
L-�C,"p,