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12620 SW 135"' Avenue
CITY
OF
T'GA R D MASTER PERMIT
PERMIT#: MST2000- 0419
DEVELOPMENT SERVICES DATE ISSUED: 9/15/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12620 SW 135TH AVE PARCEL: 2S104AC-12600
SUBDIVISION: HANDY ACRES ZONING: R
BLOCK: LOT: 032 JURISDICTION: TIG
REMARKS: addition to bed room and adding 1 bath room approx. 2.80 sq ft
BUILUING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS_ REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: :.0o sf BASEMENT. at LEFT: SMOKE DETECTORS: f
TYPE OF USE: SF FLOOR LOAD: I SECOND. S GARAGE: at °RONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT. sl RIGHT:
VALUE: S 19,571,60
OCCUPANCY GRP: R3 BDRM: I BATH: I TOTAL: :'90 rn., of REAR.
PLUMBING
SINKS. 'NATER CLOSETS: I WASHING MACH. LAUNDRY TRAYS RAIN DRAIN TRAPS.
LAVATORIES: 2 DISHWASHERS. FLOOR DRAINS. SEWER LINES. SF RAIN DRAINS: I CATCH BASINS.
TUB/SHOWERS: I GARBAGE DISP: WATER HEATERS. WATER LINES: BCKFLW PREVNTR: GREASE.TRAPS:
OTHER FIXTURES:
MECHANICAL
_ FUEL TYPES FURN r 100K. BOIL/CMP,3HP. VENT FANS. I CLOTHES DRYER:
FURN 1.100K. U141T HEATERS. HOODS: OTHER UNITS:
MAX INP: btu FLOORFURNANCES: VENTS: WOOUSTOVES. UASOUTLETS:
_ ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 0 200 amp. 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 400 arnp- 201 - 400 amp tat w10 SVC/FDR: SIGNIOUT LIN LT: PER HOUR.
LIMITED ENERGY: 401 - 000 amp: 401 800 amp. EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT
MANN IIMISVC!FDR: 801 1000 amp: 801-arnps•t000v: MINOR LABEL:
1000•ampivofl
PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS: SVCIr OR>=225 A.. >800 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL.
AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTERCOMrPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC DATAITELF.COMM NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 613.11
This permit Is subject to the regulations contained in the
BECKHAM,GARVE A +MARILYN Tigard Municipal Code,Slate of OR. Specialty Codes and
12620 SW 135TH all other applicable laws. All work will be done in
TIGARD,OR 97223 accordance with approved plans This permit will expire If
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION
Phone Phone. Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Ran 0: forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copses of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, PLM/Underfloor Framing Insp Insulation Insp Final Inspection
Fooling Insp Mechanical Insp Shear Wall Insp Rain drain Insp
Post/Beam Structural Plumb Top Out Low Voltage Electrical Final
Post/Beam Mechanics Electrical Service Gas Line Insp Mechanical Final
UnderfloorAsulation Electrical Rough In Gas Fireplace Plumb Final
Issue y : Permitteeneeded
nature : c
Call 503)639-4175 by 7:00 p.m.for an inspe- the next business day
Permit#:
O F O
V .
Address: f ZGz D AN/
Issued b Q- ��L
Date: 9'/5
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon i uw, 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 fro►n registration under ORS 701.0)0(7),
need not submit this statement. This statement will be filed with the permit.
Dill in the appropriate tanks and initial boxes l and 2, and either box 3A or 3B:
1. 1 own, reside in, or will reside in the completed structure.
(� 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale
t1� before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general .:ontractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own gene►sl contractor.
If 1 hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. fl'1 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.
1 hereby certil;Y that I lic abm v information is correct and that I have readmid do understand the Information
Notice to 1'ropery Owner. uut Contraction Responsibilities on th - reserse side of this form.
__��i 1Sign�ture of permit applicant) (Date)
(White copy to issuing ager r permit file,
pink cop),to applicant)
CITY OF TIGARD Resit (-)-Z"7- !/ Cation Plan Check#
13125 SW HALL BLVD. Recd By
TIGARD, OR 97223 Sinc iplex) / Date Recd UV-31-
V 503-6394171
l,l Date to P.E. T3/--V0
Date to DST /a-v0
F 503-684-7297 Permit#
Print or Type fDJ-;'l Called _
Incomplete or illegible applications will not be acce ted
Name of Project `— — - ---- Name �' N
Job Mallin Address
Site Address _-~^ ArOatect g
Address r1
--_� r 2 c,Z U 5 W 13 7 A V
Name City/State Zip Phone
�Y
t�q h V r� 1✓'C L����____ -- ---- me
Owner Mailing Address Name
1'�-G 20 Sw_ t A _
City/State Zip ne Engineer Mailing Address
Pho
_ __ -r► aid �7zz3 7z4-g3� �� -��� ��►�,�� �- C3Ivd
_Z.rz__.y__�_
Na City/State Zip Phone
General _ __
x_- .
2-1 L7
Contractor �.�.� rv�;_L� Describe work New Addition`Qr Alteration'O Repair O
Mailing Address -- to be done ____/^
Prior to permit s Additional Description f Work
issuance,a copy City/State Zip, Phone _A tVAC4 0 r-orli Adel 11 ttVCLQ
of all licenses
are required if Oregon Const Cont Board Exp Date PROJECT
expired in COT Lic.# VALUATION $ di oro —_J
database _
Mechanical Name ~�—�— NEW CM rRUCTION_ONLY: _
Sub- CLk)vie V ^_ Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address ---
Prior to permit Indicate the restricted energy installation by the electrical
issuance,a copy CitylState Zip Phone - subcontractor in the followin areas _
of all licenses Restricted - Audio/Stereo
are required if egon Const Cont.Board Exp. Date Energy System
Or �_ Alarms_
expired in COT Lic# Installations Vacuum Irrigation
database -System System
Plumbing Name (check ail that Other:
Sub- C>W VA(f Y apply)
Contractor Melling Address - Corner Lot i -YES NO Flag Lor YES NO
(check one) (check one)
Prior to permit City/State Zip Ph ___ Has the Subdivision Plat recorded? N/A YES NO
one
issuance,a copy ---
of all licenses are Oregon Const Cont.Board Exp.Date
required H Lic# I hearb acknowledge that I have read this application,that the
expired in COT Y 9 PP
database Plumbing LIc.# Exp. Date information given is correct, that I am the owner or authorized agent
of the owner,and that plans submitted are in compliance with
Oregon State laws. _
Name Signature of Owner/Agent---- Date
Electrical C L4,-M r Y _
Sub- Maiiing Address Contact Person Name Phone#
Contractor - — -- --
City/State ~~ Zip Phone
Prior to permit
issuance,a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Consl Cont Board Fxp Date --
required if Lic# Phi#— i M #:O
expired in COT
database Electrical Lic # Exp Date Setbacks: Zone: ., Solar:
Electrical Supervisor Lic # I
Exp.Date Engineering Approval: Planning Approval: TIF:
I kistslforrnstsladdalt doc t 1/20/98
SEE 35MM
ROLL # 21
FOR
OV11 ERSIZED
DOCUMENT
CITY OF TIGARD 24-Hour Q
BUILDING Inspection Line 4%P3'99-4171
- 75 MST
INSPECTION DIVISION Business Line: BLIP
Received _--___-__ Date Requested
AM '69 PM _ BUP
Location __ �� �-U �s `Y-� :" _Suite MEC PLM -
Contact Person -_ Ph( ) S�`L -cf 3 0 __ ,
Contractor -
Ph( ) --- SWR -_ --
Tenant/Owner
ELC
BUILDING _
Footing ELC
Foundation Access: ELR
Ftg Drain
Crawl Drain - —" SIT —
Slab Inspection Notes:
Post&Beam --
Shear Anchor
Ext Sheath/Shr,er
Int Sheath/Shear — --
Framing
Insulation •
Drywall Nailing - ---
Firewall _ ---- -
Fire Sprinkler •
Piro Alarm — -- -
Susp'd Ceiling
Roof
Other:
Fri nfibz__
- - - -
PART FAIL
— &N _ _ — —
Post&Beam
Under Slab
Rough-In --
Water Service - -
Sanitary Sewer _ --
Rain Drains
Catch Basin/Manhole - —
Storm Drain
Shower Pan ---- —
Other:
Final �-
PASS PART FAIL
MECHANICAL - - --
Post&Beam ---
Rough-In
Gas Line ----
Smoke Dampers
Final ---
PASS PART FAIL
ELECTRICAL_ --
Service —
Rough-In - --
UG/Slab
Low Voltage - --
Fire Alarm
Final ❑ Reinspection fee of s. --_--required before next inspection. Pay at City Hall. 13125 SW Hall Blvd.
PASS PART FAIL Please call for reinspection RE: Unable to inspect-no access
SITE _ [] - -- ❑
Fire Supply Line
ADA Dated ( �r Inspector --- ----_ Fxt
Approach/Sidewalk
Other: _
sinal DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING
Inspection Line: (503 175 MST ; IL
INSPECTION DIVISION Business Line: (503)67910"T BLIP -
oC
PM
Received
M _ _-- _
Received — ---
_ _ - Date Requested __-- AM-__- -
BLIP
Location _Suite— - MEC
- ---- - 1 -
PLM
Contact Person -.—--------- Ph �� _-- -- --
- SWR -- --
Contractor - - - -
/OTenantwner __ - - -- —
ELC
BUILDING -- - -
EL -
Foundation llccess: ELR -----
Fog Drain ��__
Crawl Drain SIT -
Slab Inspection Notes:
Post&Beam --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing J_.G� S
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler —
Fire Alarm _ —
Susp'd Ceiling
Roof - --- - -
PASS_ PART FAIL)
P_LUMBIN_G
PiDt&Beam --—
Under Slab _
Rough-In -"-
Water Service _
Sanitary Sewer
Rain Drains _
Catch Basin/Manhole
Storri Drain
Shower Pan _
Other'
Final - - --
PASS PART FAIL 1
MECHANICAL
Post&Beam —
Rough-In -
Gas Line
rS
a Damners PART FAIL _
_TRICAL
G@rvl a
Rough-In _
UG/Slab
Low Voltage --- _ --
Fire Alarm
Final Reinspection fee of$_----- required before next Inspection. Pay at City hall, 1:3125 SW Hell Blvd.
PASS _PART FAIL F-1 Unable to inspect-no access
SITE
_ [] Please call for reinspection RE:—. ---
Fire Supply Line
� Ext
ADA Date _- 2 6 ) Inspector -
Approach/SidewAl I
Other: ._ _.
Final I DO NOT REMOVE this `;nSPOction record from the Jobst®.
PASS PART 1-
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MSTC a% 06
INSPECTION DIVISION Business Line: (503)639-4171 BUP — —
Received I �--Date Requested-______ AM PM — BUP
-11 ��_Suite— MEC
Location PLM
/nl � Y �,/_
Contact Person — — Ph((�--"�) _�- —
Gontracto _--
Ph� ) ---- SWR —
UILD Tenant/Owner _ — EI.0
Foo ing 0.10 _—
Foundation Access: ELR
Ftg Drain
Crawl Drain SIT
spection NSlab Inot }vQ LVN-171
Post Beam 2 r` „ (� \ —
Shearr Anchors �,2,�1,,� � `� �
Ext Sheath/Shear
Int Sheath/Shear _ -
Framing
Insulation —
Drywall Nailing
Firewall _ ---
Fire Sprinkler — � I p ' ��-,✓
Fire Alarm
usp'd Ceiling
R
RoofOth
ina
CL
ASS_PART FAIL uta^ <
PLUMBING , —
Post&Beam --
Under Slab ` Q
Rough-in —
Water Service
Sanitary Sewer —
Rain Drains
Catch Basin/Manhole —
Storm Drain
Shower Pan ---Other-
Final
ther Final _
PA T FAIL
ECHANI L — - -- —
Post earn
Rough-In -
Gas Line
Smo�Dampers -
�nei _ -
--W6S PART _ FAIL. - ----
ELECTRI_CA'_
Service
Rough-In -_ — -- ----
UG/Slab _ —_—_`—
Low Voltage �-
Fire Alarm
Final ❑ Reinspection fee of requirod before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
dl-E - ❑ Ploase call for reinspection R_E Unable to inspect-no access
:Y— — ❑
Fir 'n apply Line
ADA Date— _ Inspector ___— - - K
Approach/Sidewwlk `-
Other.
sinal DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
W
CITY OF TIGARD BUI" 71NG INSPECTION DIVISION MST
24-Hour Inspection Line: 639 . X75 Business Line: 639-41, .
BLIP _
_ Date Req-ested — —AM---PM — BLD
Location 4- '_' �`� .� /Tu Suite MEC A
Contact Person �✓Lt�— Ph 7 y �` �% PLM
Contractor Ph SWR
BUILDING 1-enant/Owner _ ELC —
?etaining Wall ELIR
Footing Access
Foundation FPS
Fty Drain G�'e� / ------ h �'` SGN
Crawl Drain Inspection Notes: ---- -
SlabSIT
-- -
Post&Beam ---�_A----
Ext Sheath/Shear - -----------
Int Sheath/Shear
Framing -- -- --- --- - - --- _ —
Insulation
Drywall Nailing — --- -- -- - - - - ---
Firewall
Fire Sprinkler ---- -- -- ---- _
Fire Alarm
Susp'd Ceiling
Roof
Misc: --- ------- ——
Final
PASS PART FAIL_ ----
PLUMBING
Post& Beam
Under Slab a-f a
Top Out
Water Servic?1-
Sanitary Sewer _Qi l —
Rain Drains `V�
i
PART FAIL
WWDftNICAI-
Post
Rough In
Gas Line
Smoke Dampers
Final - - -------- ----
PASS PART FAIL _
ELECTRICAL
Service -
Rough In
UG/Slab
Low Voltage
Fire Alarm -
Final
PASS P%RT FAIL -- ---- - ---
SITE ---
Backfill/Grarling
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at Ci.y Hall, 13125 SW Hall Blvd
Catch Basin Unable to inspect-no access
Fire Supply Line [ J Please call for reinspection RE=:_ [ J
ADA
Approach/Sidewalk Date / �% 21 &f/ Inspector T, y
Other -- Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
C!-',"Y OF TIGARD PI)ILDING INSPECTION DMSO^N
2? Hour Inspection Line: 9-4175 Business Line: 63;, 4171 MST ZOO 6,'
8UP
----Date Requested 4, 13 — AM_ PM BLD
Location5 cw / 17 s n Suite
MEC
Contact Person _ Ph J�7 _ Gj.'- PLM
Contractor-________ Ph _ SWR
BUILDING _ Tenant/Owner _ _ ELC
Retaining Wall -�- —
Footing ELR
Foundation Access:
1 Fig Drain FPS
Crawl Drain Inspection Notes SGN
Slab --
Post& Beam — — SIT _
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation - -
Drywall Nailing ,
Firewall _ // -----
Fire Sprinkler
Fire Alarm I �`— /
Susp'd Ceiling
Roof
Misc:
Final -- -- — --- ---- ---
PASS PART FAIL
PLUMBING -
M_
Poct 8 Beam -- __ --_ -
Under Slab
Top Out - - -- ---
Water Service
Sanitary Sewer - - --
Rain Drains
Final
PASS PART FAIT_
MECHANICAL _ -
Post& Beam ---- _ -_
Rough In - —
Gas Line
Smoke Dampers
Final
--PASS-_ _P/4RT FAIL
• RI --
Service
Rough In -
UG/Slab
Low Voltage
larm
-
PA�S FART FA:L
TES
Backfill/Grading -- - - _
Sanitary Sewer
Storm Drain j Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for inspection RE _ [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other _ Date -`! 7 _ Inspector l;�Ci'�r�� _Ext
Final /
PASS PART FAIL J DO PICT REMOVE this inspection record from the job site.
SFE 35MM
RILL #21
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