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Page No. 1 CASE HISTORY POR CASE NO.: MST96-02.3
CAHN PROPERTIES LIMITED PAR'.
11.511 SW 98TH AVE
08/06/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA005 Application received 05/08/96 / / 04/26/96 PASS JA O5/�8/96 b :
MSTA008 Permit Created 05/OB/96 / / 05/08/96 PASS RT 05/08/96 BT2
MSTA010 Check for prcl. restrict. 05/08/96 / / 05/03/96 PASS JA 05/08/96 BT2
MSTA012 Plans routed to Plans Examiner 05/08/96 / / 05/03/96 PASS Atli 05/08/96 BT2
MSTA026 Plans approved by Plans Exmr 05/ )6 / / 05/08/96 PAS`; RT 05/08/96 BT2
MSTA030 Rev'.ewed plans sated to DSTS (j9, , .,/96 / / 05/08/96 PASS RT 05/08/96 BT2
MSTA092 (F) Issue combination permit / / / / OS/14/96 PASS B 05/14/96 BON
MSTA700 Erosion Contol / / / / / / small addition PASS 06/20/96 RB
MSTA705 Footing Disp / / / 06/20/96 PASS RB 06/20/96 RB
MSTA")6 Founaation Insp / / / 06/20/96 PASS RB 06/20/96 RB
MSTA-110 Pobt/Beam Structural / / / / 06/27/96 APP GS 06/27/96 GES
MSTA712 Underfloor insulation / / / / 06/27/96 APP GS 06/27/96 GES
MSTA717 PI.M/Underfloor / / / / 06/27/96 APP GS 06/27/96 GES
MSTA720 Mechanical Insp / / / / 07/09/96 APP GS 07/11/96 GES
MSTA722 Plumb Top Out / / / / 07/09/96 APP GS 07/11/96 GES
MSTA723 Electrical Service / / / / 07/09/96 check panel at final APP GS 07/11/96 GES
MSTA724 Electrical. Rough In / / / / 07/09/96 AFP GS 07/11/96 GES
MSTA725 Framing Insp / / / / 07/ 9/96 APP GS 07/11/96 GES
MSTA740 Insulation Insp / / / / 07/ 0/96 APP GS 07/11/96 GES
MSTA745 Gyp Board Insp / / / / 07/12/96 APP GS 07/12/96 GES
MSTA755 Rain drain Insp / / / / 07/30/96 PASS MS C7/31/96 MRS
MSTA790 Electrical Final / / / / 07/30/96 PASS MJR 07/30/96 MJR
MSTA795 Mechanical Final / / / / / / N/A 07/31/96 GES
MSTA797 Plu^ib Final / / / / 07/30/96 PASS MS 07/31!96 MRS
MSTA799 Building Final / / / / 07/31/96 AFP 7S 07/31/96 GES
MSTA970 Case Finaled / / / / 07/31/96 APP GS 07/31/96 GES
t'
j City of Tigard, Oregon c��`,,,.�-
` Rapid Damage Assessment Form
BUILDING')ESCRIPTION: 1 OVERALL RATING: (Check one)
Name: � `fit G�e_l 1`-V-� INSPECTED(Green) �.
_ _ Exterior only
Address: _ \ ct k7 _,Exterior &Tnterior
LIMITED ENTRY (YeUow) U
No.of Stoiies: ? UNSAFE (Red) ❑
Basement Yes ❑ No Unknown C3
INSPECTOR:-
Primary
NSPECTOR:Primary occupancy: Dwelling U Inspector ID
Affiliation
Other Residential O Commercial A-- Office ❑
Industrial O Public I membly U School U INSPECTION DATE-
Government
ATEGovernment U Eme•.Serv. O Hospital ❑ Mo/day/year -2 .--1 -
Tune pm
Other
Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2,3, or 5 is grounds for
posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY. A "yes" answer to 4
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 More Review
_Needed --
l. Collapse*,partial collapse,or building off foundation ❑ —�/� ❑
d 2. Building or std noticeably leaning 0 CJ L3
3. Severe-eking of waill,�bvious severe damage an distress jb ❑
4. Chimney,parapet or oilier falling hazard ❑ ❑
5. Severe ground or slope movement present ❑ U
6. Other hazard present: �1� �� ��e_��-- O ❑
Recommendations:
�-No further action required _
Detailed Evaluation required (circle onetru_c�.)Geotechnical Other
M ❑ Barricades necacd in the following areas:
❑ Other.
w
W
Posted at this Assessment: Occupants Notifiacate Temp Ho Req.
Rey.
❑Yes Flo ❑YesVIZ ❑Yes �10 ❑ 7
Comments:
Estimated Damage ❑ 0% JU 25% O 50% 0100% $
6-� OFFICE USE ONLY
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection
Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
inspection: `�'G V�/`_ _C �; /�-- � _�>S Iv
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundatioi Plbg. Underslab Mech. Rough-in Fireplare
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
G
Date Requested: l Z o S Time: AM _PM
Address: J�c') [ f- "
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
c r�Inspector__ Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
(� Cali For Reinsp.
MASTER PIERMIT
CITY OF TIGARD f:'ERMIT #. . . . . . „ MST96_ 0:
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05 14 96
13125 SW Hall Blvd.Tigard,Oregon 97223.8'99 (503)836-4171
P'ARCE:1_: IS 135CD--00900
ITh ADDRESS. . . : 1151 .1. SW 98 AVI-
_;UBDIV161L71V. . . . : HURLWOC)U ZUNING: R-•12
;A1_(JCK. . . — . . . . LC)T. . . . . . .. . . . . . . .
Remarks: ADDING 1 BATH AND ONE BED ROOM 315SQ FT PATH I
---------------------------------------------••----------------- BUILDING ----------------------------------------------------------------
REISSUE: STORIES.......: 1 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-----------
CLASS OF WCRK.:ADD HEIGHT........; 13 FIRST....: 315 sf GARAGE.....: d sf LEFT..........: 0 SMOKE DETECTRS: Y
TYPE OF USE...:SFA FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: @
TYPE OF CONST.:5N DWELLING UNITS: I FfNBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.:R3 BDRM: 1 BATH: 1 TOTAL------: 315 sf VALUE..6: 20368 REAR...,......: 27
--------------------------------------------------------------- PLUM106 -------------------
SINKS.........: 0 WATER CLOSETS.: I WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 1 DISHWASHERS.... 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS .: 0
TUB/SHOWERS...: 1 GARBAGE DISP..: @ WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIXTURES: 0
- - MECHANICRL --------------------------------------------------------------
FUEL TYPES------- --- FURN ( 1@@K ,.; 0 BOIL/CMG ( 3HP: 0 VENT FANS.....: 1 CLOTHES DRYERS: 0
/GAS/ / / FURN )-t@0K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 6
MAX 14P.: @ BTU FLOOR FURNACES: 0 VENTS.........: 2 WOODSTOVES.... : 0 GAS OUTLETS...: 0
-------------------------------------------------------------- ELECTRICAL ------------- ------------------------•-----------------
--RESIDENTIAL UNIT--- ---SERVICEiFEEDER---- --TEMP SRVC/FEEDERS-- ••--BRANCH CIRCUITS--- ----MISCELLANEOUS----• --ADD'L INSPECTIONS-
1000 SF OR LESS: 1 0 - 200 amp..: 0 0 - X00 amp..: 0 W/SVC OR FOR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5@OSF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st 4/0 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR...... : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 4@1 - 600 amp..: 0 EA ADDL BR CIN; 0 516NAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 10@0 amp.: 0 601+amps-10@0 v: @ MINOR LABEL -1@: 0
1000+ amp/volt.: @ -----------------------------•------ FLAN REVIEW SECTION --------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SSC/FDR)=225 A.: ) 60@ V NOM144L: CLS AREA/SFC OCC:
-------•----------------------•---------------------- ELECTRICAL - RESTRICTED ENERGY -------------------•-----------------
A. SF RESIDENTIAL----------------------------- B. COMMERCIAL------- ----••-------•---- ----------------------------------------------------
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO b STEREO.: FIFE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC Ll:
BURGLAR ALARM..: 0TH: :: BOILER.........: HVPC...........: LANDSCAPE/IRR1G: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL......... OTHR:
HVAC...........i DATA/TELE CO'M.: NURSE CALLS....: TOTAL M SYSTEMS: 0
Owner: ----------------------- -------------------------- TOTR. FEES:{ 40.11
LAHN PROPERTIES LIMITED PART. OWNER
5795 SW CRANBERP•Y CT
PEAVERTON OR 970@7
-one e: 627-0153 Phone M:
Reg C.: 13125
n;
his permit is issued subject to the requlations contained in tho Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws, All work will be done in accordance with approved plans. This permit will expire if work is net started within IPP
days of issuance, or if work is suspended for more than 180 days,
--------- REQUIRED INSPECTIONS --------------------------------
CC
Erosion Contol Crawl Drain Electrical Rough Electrical Final
ioating Insp PLM/Underfloor Framing Insp Mechanical Final
Foundation Insp Mechanical In;p Insulation Insp Plumb Final _
Post/Bean Struct Plano Top Out Gyp Board Insp Building Final _
Underfloor insul Electrical Servi Rain drain Insp
- r
1 er•miUt;ee 3igr7atr-rrH : -_. _ _ .. ...-. _ ..-_.-._ . Isstied Dy :
Call for- irlspectirin - 639--4175 dtL r
_���
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: EL-C96-0436
13125 SW Hall Blvd.Tigard,Oregon 97123e8199 (503)639.4171 DATE ISSUED: 07/03/96
PARCEL: 1S135CD-00900
aITE ADDRESs. . . : 11511 :AW 1.j81H OVI_
:SUBDIVISION. . . . : BURLWOOD ZONINBPR-12
BLOCK. . . . LOI.. . . . . . . . . . . . .
Project Description:
-------------------------------------------------------------------------------------
UNIT------- ----TEMP SRVC/FEEDERS---- ------MISCELLANEOUS---
1000 3F OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
C.ACH ADD1L 500SF. . . : 0 201. 400 amp. . . . . . . .. 0 SIGN/OUT LINE LTG. . : 0
i.-IMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF"'. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . : 0
-----SERVICE/FEEDER------- ----BRANCH CIRCUITS--- --- ---ADD' L INSPECTIONS----
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . 0
c'1211 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER HOUR. . . . . . . . . . . : 0
401. 600 amp. . . . . . : 0 EA ADD"— BRNCH CIRC: 3 IN PLANT. . . . . . . . . . . . 0
601 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION----------__-___.__
:000+
ECTION------------------
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . ii > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR )zj 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: FEES ------------------
L,'AHN PROPERTIES LIMITED PART. type afflOUnt by date recpt
!J-795 SW CRANBERRY CT P R im"r $ 50. 00 JSD 0'7/03/96 96-281313
5FICT $ 2. 50 JSD 07/03/96 96-281313
6EAVERTON OR 97007
Phone #s 627-0153
L:ontractor-- ----------------------------------------------------------------------------
ELECTRIC $ 52. 31a TOTAL
ROBERT A CARON
/831 SE JOHNSON CK BLVD REUUI RED INSPECTIONS
PORTLAND OR 97206 Ceiling Cover Elect' ] Final
Phone #. Wall cover
Reg #. . : 034255
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signeture
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days. I Sued )By
!NSTALLATION
The installation is being made an property I ow,1 which is not intended for-
rx sale, lease, or rilynt.
OWNER' S SIUNATURE: DATE:
INSTALLATION
_j
SIGNATURE OF FjUPR. ELELINii DATE:
ICENSE NO:
Call for, inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued �r .
Phone (503) 639-4171
CITY OF TIG�RD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
7. Job Address;: � 4. Complete Fee schedule Below:
Name of Development Number of Inspections per permit allowed
Address //,5 fz S Gv y }� i~�f i Service included- Items Cost(ea) Sum
City/State/Zip__ /�i,�� 4a. Rrsidenti3l -per unit
1000 sq. ft. or less $11000 _� 4
Name (or name of business) Each additional 500 sq ft or $25 QO
portion thereof
Commercial ❑ Residential I� Limited Energy $25.00 _ 1
Each hAanufd Horne or Modular
Dwelling Service or Feeder $6800 _ 2
2a. Contractor installation only:
4b. Services or Feer'9rs
Installation,alteration,or ruocation
Electrical Contractor -,+o�S ����L 1�"�� � ?00 ernes��r less $60,00 2
Address/� 3/ %1 (rj,��//✓�L� L �L�"/-7 I 201 amps to 400 amps $60 00 2
401 amp3 to 600 amps $120.00 2
City_ 9a �T/;-J� 1L_ State c� � Zip�7 --
60+amps to 1000 amps $160.00
Phone No. i 7,z S^s'� y / __ I Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $5000 _ 2
contractor's license NO. 5-773 C" ______ 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 241 - ;ns,allaunn,alteration,or relocation
Signature of Supr. Elec' _ cc�� _ 100 amps of less
20'amps to 400 amps $50.00
License No.��-�S �S Phone No 7Z • t 401 mps to 600 amps $r,.00
Over t V amps to 1000 volts 3100 00 ---
2b. For owner installations: see"b'above
4d. Branch Circuits
Print Owner's Name____ New,alteratrcn or extension per pane
Address a)The fee 1 it branch circuits with
Cit State Zip__ purchase of service or feeder tae.
City — _ Each b�at ch circuit $500 _
Phone No. b)The fee fo branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee
First
not intended for sale, lease or rent. _ s35 00
Earbranch circum h add�tlonal branch circuit �_ $5.00
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or Irrigation circle $4000 2
Each sign or outline lighting $4000 _
Sig,•al chcutts)or a limited energy
Please check appropriate Item and enter fee In section 5B. pane;,altereuon or extension _ 34000
4 or more residential units in one structure Minor Labels(1o) $10000
Service and feeder 225 amps or more
_System over 600 volts nominal 4f. Each additional Inspection over
_Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 Per inspection $3500
Per hour 355 tX1 T-
-- In Plant ___ 55500
Submit 2 sets of plans with application where any of the above _ �—
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ _
NOTICE 5% Surcharge (05 X total fees) $ ,—
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%o,line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3)
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account Ar
$
Balance Due a r