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I ; �'� •� „ -/ TRIL AND ,DESIGN GROUP, INC. - fIRE HYDRANT
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C I 3 -- / 10160 S.W. NIMBUS AVE. (] - WATER METER
I - i IGARD, OREGON 97113
' 1 i I 0 - SAN►TARY SEwfR MAN UE
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$� 4' WEST Of END Of CURB.
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No.36
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ORIGINAL DOCUMENT E g Z 8 Z L Z 8 Z 4 Z fi Z E Z Z T Z O Z g i S T G T � � — •'� � -
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11130 SW Fonner Street
BUILDING PERMIT
CITY OF TIGARD
PERMIT#: BUP2002-00434
DEVELOPMENT SERVICES DATE ISSUED: 10/3/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AC-01600
SITE ADDRESS: 11130 SW FONNER ST
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG_
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK- N L.'`f FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: rF 3c'?C)U C)c'>
Remarks: Reconstruction of carport removed for development of new subdivision.
Owner: Contractor:
NUPARK DEVELOPMENT LLC INTERLOCKING ENTERPRISFS INC_
8765 SW HILLVIFW TERRACE 10740 NW CORNELIUS PASS RD
PORTLAND, OR 97226 PORTLAND, OR 97231
Phone: 503-504-1998
531-3635 Phone: 531-3635
Reg #: LIC 00090272
FEES REQUIRED INSPECTIONS_ _
Description Date Amount Footing Insp
JBIJI .1)I I'cmiil 1 rr 10/3/02 — $72.10 Framing Insp ./
Misc. Inspection -
JBIJ11.DI 1'ernut I-ec 10:3/02 $0.00 Final Inspection
ITAS 181%)Stage Tax 10/3/02 $5.77
[TAX 181!/(,State Tax 10/3/02 $0.00
(additional fees not listed here)
Total $124.74
This permit is issued subject to the regulations contained in the Tigard Municipal Cude, State of OR Specialty Codes
and all other applicable iaw. All work will be done in accordat cp with approved plans This permit will expire if work is
not started within 180 days of issuance, or if worts is Suspended for more than 180 days. ATTENTION Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Ceni„r. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100 You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-6699 or 1-800-332-2344.
Issued Bic: ,, __—
Pemi0ee - --'�
Signature: `. .Z �-.• —---- -----
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Applicatioa
/
City
received: �0 �a' Permit no.• �� .r
City of Tigard
Projec
Address: 13125 SW Hall BINd,Tigard,OR 97223 Uappl.no.: Expire date:
�'ur,/'I7�r,rJ Y� P bate issued: 8 Receipt no.:
Phone: (503) 639-4171
Fax: (501) 599-1960 Case file no.: Payment type:
Land use approval 1&2 family:Simple Complex:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Additionlalteraliun/replacement U'renant improvement U fire sprinkler/alarn) U Other:
q, .1011 SITL INFORMATION
Job address: 1�3 U 5'W F v V e_ 1_ S Bldg.no.: Suite no.:
Lot: I Block: Subdivision: _ Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
I
-ORNI%I ION, USE UIIECKLIST
OWNER I )R Sill IAL INI,
(1-loodplain,septic capacity,solar,etc.)
Name: ,Gv /w �-
_Mailing Adress: 7 �''fGaJ Ag,e.,j " ,t�z2 1 &2 family dwelling:
City: State:eye ZIP: Valuation of work............................1 .......... $ 3Gd 0.
Phone: o ax: E-mail: No.of hedrooms/baths................................. ---
t)wner',,representative: Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq, ft.) ..........................
Garage/carport area(sq.R.).........................
Name: Covered porch area(sq, ft.) .........................
Mailing address: Deck area(sq. ft.) ........................................
City: State: ZIP: Other structure area(sq. ft.).........................
Phone: Fax: E-mail' Commercial/industrial/multi-family:
Valuation of work........................................ $
Existing bldg.area(sq.ft.) ..........................
Business name:---- C-
New bldg.area(sq.f.)................................
Address: NIN �,� / Number of stories
City: � �w..v�.f State:i�drt ZIP: -C � I ........................................ --
r 'Erse =_mail: type of construction....................................
Phone:y 0
3 S� r`
s�1d 7 �� Occupancy group(s): Existing:
CCB no.:
—�� - New: _.
City/metro lie.no.: Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: — jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Contact Ix.rson: ---- Plan no.: -
Phone: -- - I ,t� E-mail' ----
201HILINNE4 __
Name: Contact person: Fees due upon application ........................... $
Address: Date received:
State: ZIP: Amount received
City: ......................................... $
Phone: Fax Email: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Nor all jurisdictions accept credit rant pleau call iudWicaon for more information.
attached checklist. All provisions of laws and ordinances governing this Uviaa U Mastercard
work will be cornplied-withi-thuther specified herein or not. Cie&cord number
101-4110Z — Expires
Authorized sig _—�S Date: Name of cardholder u shown on credit card
Print name:— Ck� — —— Cardholder dtinature v Amount
�',,)tice:lliis Ix rmit application expires if a permit is not obtained within 180 days after It has been accepted as complete. Motel a 160WOMi
One- and Two-Family Dwelling
Building Permit Application Checklist Reference no.
Associated porn n a,
0yofTigard City of Tigard U Flectrical U Plumbitty J Mechanical
Address: 13125 SW Fall lilvd,'I•igard,OR 9722:3 UOther:
Phone (503) 639-4171
Fax: (5( i) 598.1960
1Twal 1111111 ociiii
I band use actions completed.See jurisdiction crilerw tau m,_i irrent reviews. _
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved plat/lot. —
4 Fire district approval required.
5 Septic system permit or authorization for renhodel. Existing system capacity
6 Sewer permit. - —
7 Water district approval.
8 Soils report.Must curry original applicable stamp and signature on file or with application. _
9 Erosion control U plan U permit required. Include drainage-way protection,silt fence design and location r.r
catch-basin protection,etc,
IO3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and slate
building codes. lateral design details and connections must he incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references hetween plan h-tiitm and details. flan review cannot he completed
it copyright violations exist. _ _
I I Site/plot plan drawn to scale.'I'he plan must show lot and hudding setback dimensions;property comer elevations(if'
drere is moll.tluan it 4-11,elevation differential,plan inrr,t s114 �k c. ntour lines at 2-I1.intervals);location of casements and
alriveway;footprint of structure(including decks);10LAN111 of \Nells/sepu( systems;utility locations;direction indicator;lot
area;building coverage arca;percentage of coverage;impervious aura;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolls,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location or smoke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc,
14 Cross section(s)and details.Show all framing-member si/es and spacing such its floor brooms,hcatdcrs,joists,sub•Iloor.
wall construction,roof constnaction.More than one cross section may he required to clearly portray consir uction.Show
details of all wall and roof sheathing,roofing,r(xol'slope,ceiling height,siding material,footings and foundation,stairs.
fireplace construction, themed insulation,etc,
15 Elevation views.Provide elevations for new construction;tninimum of two elevations for additions and remodels.
6xrerior elevations nwst reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references arc acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
nonprescriptive path analysis provide Specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof•assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. ror engineered
systems,see item 22,"Engineer's calculations." _
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple Joists
over 10 feet long and/or any beam/joist carrying a not..uniform load.
20 Manufactured floortroof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof tniss)shall be stamped by an engineer or
architect licensed in Oregon and shall hC shown Jobe aapplicab1C to the pnoJect under review
JURISDR-11
23 Five(5)site plans are required for Item I I aho\e. Site plans must he 8 112" .r I I' or 11" x 17
24 Two(2)sets each ate required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Reversed"building plans must meet criteria outlined in the Permit& System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and CUT Street Tree List
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 4404614(MCOM)
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TERRY J. DONDINO
NTERLOCKING CCB#90272
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uuality home building and carpentry service.
OA7re: 503.531.3635 Cell:503.519.5662 • 10740 NW Comellus Pass Rd., Portland, OR 97231
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ERLOCKING TERRY J. DONDINO
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Office.,503.531 3635 • Cell.-503.519,5662 • 10740 NW Cornelius Pass Rd., Portland, OR 97231
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES E ISSUED:
#: S26/02 00152
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4!26/02
PARCEL: 2S 103AC-01600
SITE ADDRESS; 11130 S1N FONNER ST
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE.: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Connect existing house to sewer lateral.
Owner: _FEES_
NUPARK DEVELOPMENT LLC Type By Date Amount Receipt
8765 SW HILLVIEW TERR --- --
8765 S HI VI 97225 PRMT CTR 4/26/02 $2,`300.00 27200200000
PORINSP CTR 4/26/02 $35.00 27200200000
Phone: 503-297-6551 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections_
Sewer Inspection
Septic Tank Filled
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so Iccated, the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: � � ' ,_.... ,_Y–�—
Permittee Signature:'
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
w•
CITYOF TIG ARD PLUMBING PERMIT
PERMIT P
DEVELOPMENT SEWCES 26/02 00138
DATE ISSUED: 4/26/02
13125 SW Hall Bl,,d.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S103A.0-01600
SITE ADDRI7.SS: 11'130 SW FONNER ST
SUBDIVISIOW ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 40 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of approx. 40 ft. of sewer line to connect to sewer lateral.
Septic, tank is to be pumped, filled or removed and inspected
__F_E E S
Owner: Type By Date Amount Receipt
NUPARK DEVELOPMENT LI-C PRMT CTR 4/26/02 $72.50 272.00200000
8765 SW HILL.VIEW TERR 5PCT CTR 4/26/02 $5.80 27200200000
PORTLAND, OR 97225 — — --
Total $78.30
Phone 1: 503-297-6551
Contractor:
REQUIRED INSPECTIONS
Sewer Inspection
Phone 1: fi��
Reg #: I-n,al Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
1Iou may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: , �r �1,� �C1� �� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
I�Uha°v, - o�
`(d I o,;� -00 15 �-
Plumbing Permit Application
Date received: p Z Permitno.: (,n
City Of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
01v of Tigard Phone: (503) 639-4171 - ProjecVeppl.no.: Expire date:
Fax: (503) 598-1960 7 /t"�) bate issued: By: Receipt no.:
I i
Land use approval: rase file no.: Payment type:
U I &2 family dwelling or accessory U Commercial/industrial J N1111u-Gunn} U Tenant improvement
U New construction U Add ition/al teration/replaccnicnl _1 Food tier\iU Other:
Job address: '' �(�) f`, /:
Description Qt}'. heti(ea.) 'Ibtal
Bldg.no.: Suite no.: Ne" I-and 2-Tamil}dhellings only:
— -- -- (includes 10011.for each utility connection)
Tax map/tax lot/account no.: SIR(1)hath
Lot: Block: Subdivision: SFR(2)bath
Project name: SFR(3)bath
City/county: ZIP: Each additional bade/kitchen
Description and location of work on premises: if/N/ ilteutllities:
'ch basin/area drain -- -- ----
Est.date of completion/inspection Dry wells/leach line/trench drain --
t Footing drain(no.lin. ft.)
Manufactured home utilities _
Business name: w'R X ul. ' , Manholes
Address: ;),, N20(1 t r r ` I V C_ Rain drain connector _
City. le- r-) State: ZIP: Cl p OT Sanitary sewer(no.lin.ft.)
Phone: r' 7- Fax: Email: Storm sewer(no.lin.ft.)
CCB no.: f ;�( �(�� Plumb.bus.reg.no: Water service(no.lin.ft.)
City/metro tic.no.: � Fixture or item:
Absorption valve
Contractor's representative signature'..._ r
Back flow preventcr
Print name: -Backwater valve
Basins/lavatory _
Name: Clothes washer
Address: - --- -- - Dishwasher ntain(s)
-
Drinking fou
City: State: 7.IP: Ejectors/sum
Phone: E-mail: Expansion tank -- -
Fixture/sewer cap _
Name(print): Poo k iI L l � Floor drains/floor sinks/huh _
-- Garbage disposal
Mailing address_— '(o Hose bibb _ —
City: ,,,f State: . j ZIP: Ice maker
I'honr: --- Fax: E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s) _
will he made by me or the maintenance an(]repair made by my regular Roof drain(commercial)
employee on the property I ow s per ORS Chapter 447. Sink(s),basin(s),lays(s) — _
Owner's si natur : - �" -'b pure: _ �� Sum _
Tubs/shower/shower pan
Urinal _
Name: _— -- Water closet
Address: Water heater
City: State: ZIP: Other. —_�— ----
Phone: I E-mail: Total
Not all urisdi,dons aces credit cards,please call jurisdiction for tnom Infotrrurion Minimum fee................$
) M 1 Notice:llris permit application
Uvisa UMasterCardexpires if a permit is not obtained
review(at — %) $
s been State surcharge(8%)....$ —"�—
Ctedlt cant number _ Ires within 160 days after it has been
accepted as complete. TOTAL .......................$
Nana of cardholder as shown on credit card
Cardholder signature Amount (s' t N♦ r r' G' 4404616(MOCOM)
33t ov
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES individual) QTY ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL-�
Sink ► 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 _ for each utiles connection)_ —
Tub or Tub/Shower Comb — 16.60 One 1 bath — $249.20
__ Two 2 bath_ _ __$350.00
Shower Only 16.60 Three 31bath _ $399.00
Water Closet _ — 1660 SUBTOTAL
Trinal 16.60 8%STATE SURCHARGE
Dishwasher — 1660 _PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.50 __TOTAL —
Laundry Tray — — 1660
Washing Machine 16.60
Floor Drain/Floor Sink 2" i 16.60
3" 1660 PLEASE COMPLETE:
4" 16.60 _
Water Heater O conversion O like kind 1660 — Quantic by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. _ Capped
MFG Home New Water Service 46.40 Sink
MFG Horne Now San/Storm Sewer — 4640 Lavatory
-- — Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 1660 Shower Only
Drinking Fountain 16.60 Water Closet
Other Fixtures(Specify) 16.60 Urinal _
_ Dishwasher
Garbage Disposal _
--- — — Laundry Rorm Tray
--
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100' 4 a h 55.00 3" —_—
Sewer-each additional 100' 4640 �— 4" _
Water Service-1 st 100' 5500 Water Heater — —.
Water Service-each additional 200' 4640 Other Fixtures
S ecif
Storm&Rain Drain- 1st 100' 5500
Storm&Rain Drain-each additional 100' 46.40 _
Commercial Back Flow Prevention Device 4640 -- — —
Residential Backflow Prevention Device' 27.55 -- —
Catch Basin — 16.60 --
Inspection of Existing Plumbing or Specially 6250
Requested Inspections _— per/fir _ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25
Grease Traps 1660 —
QUANTITY TOTAL — -�
Isometric or riser diagram Is required if
Quantity Total Is >9
`SUBTOTAL — —
81/6 STATE SURCHARGE —
"PLAN REVIEW 25%OF SUBTOTAL
Required only If fixture qty tolal Is>9 _
TOTAL $
'Minimum permit roe is$72 50•8%state surcharge,except Residential Backflow
Prevention Device,which is$36 25-8%state surcharge
**All New Commercial Buildings require 2 sets of plans with isometric or riser
diagram for plan review.
i:\d3ts\forms\plm-fees.doc 12/26/01
BUILDING PERMIT
CITYOF TIGARD PERMIT#: BUP2002-00105
DEVELOPMENT SERVICES DATE ISSUED: 31'10102
13125 SW Hall Blvd.,Tigard. OR 97223 (5031639-4171 PARCEL: 2S103AC-01600
SITE ADDRESS: 11130 SW FONNER ST ZONING: R-4.5
SUBDIVISION: LOT: JURISDICTION: TIG
BLOCK:
FLOOR AREAS EXT ERIOR WALL CONSTRUCTION
REISSUE: S: E W:
CLASS OF WORK: DEM FIRST: sf N.SECOND: sf PROJECT OPENINGS? _
TYPE OF USE: SF sf N; S: E: W:
TYPE OF CONST:
OCCUPANCY GRP: TOTAL AREA: 0.00 st ROOF CONST: FIRE RET?
BASEMENT: sf AREA SEP. RATED:
OCCUPANCY LOAD: GARAGE: sf OCCU SEP. RATED:
STOR: HT: ft REQUIRED
BSMT?: MEZZ?: REQD SETBACKS ft FIR SPKL: SMOK DET:
FLOOR LOAD: psf LEFT: ft RGHT: FIR ALRM HNDICP ACC:
DVJELL!NG UNITS: FRNT: ft REAR: ft PRO CORR: PARKING:
BEDRM5: BATHS:
IMP SURFACE:
VALUE:
Remarks: �emulitwn of (2) small sheds, app roximately 300 sq ft and 400 sq ft each. All demolition debris is to be removed
from site.
Contractor:
Owner:
NUPARK DEVELOPMENT LLC
NUPARK DEVELOPMENT LLC 8765 SW HILLVIEW TERR
8765 SW HILLVIEW TERR PORTLAND,OR 97225
PORTLAND, OR 97225
Phone: 503-297-6551
Phone: 503-297.6551 Reg #: Lu; 14977s
— — REQUIRED INSPECTIONS
- FEES -
-----'--'---- Final Inspection
-Type By Date Amount Receipt
PRMT CTR 3/20102--$62.50 27200200000
5PCT CTR 3/20i02 $5.00 21200200000
Total $67.50
1"his permit is issued subject to the regulations contained
finedaccin the girwithd approved Code,T t State
ofperOi will expireSpecialty
wode is
and all other applicable law. All work will be donean days. ATTETI .
not started within 180 days of issuance, or if work ssuspended for catore ion Clenter80Those rules aNe seNforOtl]�n OAR
gon law
requires you to follo��i the rules adopted by the Oregon Utili y Notof these rules or direct questions to OUNC ]y
952-001-0010 through OAR 952-001-1987. You may obtain a copy
calling (503) 246-6,399 or 1-800-332-2344.
Permittee �* _r
Signature: —LL
Issued Ey:
Call 639-4175 by 7 p in. for an inspection the next business day
Building Permit Application
Date received: �.'4 j Permit no.:
City of Tigard project/appl.no.: Expiredate:
CirynjTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 ;;Ak&pw/-Oe*0`}�. Case file no.: Payment type:
Land use approval: c CX"1 - L cf'-f-`>.!� �'! I&2family ti rnl,lr Complex:
I]1 &2 family dwelling or accessory U Commercial/Indusowl J Multi-Iamily U New construction XUcnu,hoon
U Addition/alterltion/replacemcnt U Tenant impnrvenurnl U Fire sprinkler/alarm U Other:
INFORMATION
Joh athhrsti: Ju :�; " z w-t/? / Bldg.no.: Suite no.:
l.ot: Blo—ck:- Subdivision: Tax map/tax IoUaccaunt no.: ,;1 S' / T L E�x
Project name: t /Y -
Description and location of work on premise speci end ions: lit
Name: it � F R 'L � .�. .. C� � ,. ,
C Lt. c -
Mailing address: � ' _ I &2 family dHe,ling:
--
City: t,.� �l
ft
State. ZIP: Valuation of work.
Phone: t rax: .' E-mai .ol'bcdrooms/baths.................................
Owner's repo cntative; �f t Total number of floors............•................ ...
Phone: I'ax: E-mail: New dwelling area(sq.ft.) .......................... _
Garage/carport area(sq.ft.).........................
Covered porch arca(sq. I't.l .........................
Name: ; ,t
----- - - ---- -- Deck ansa(sq.I't.) ................. _
Mailing address: r
- — Slate: ZIP: Other structure area(sq. ft.)
..........
Other
City: -- Commercial/industrial/multi-family:
I,ir I until $
Valuation of work..........................•........,6 low .
Existing bldg.area(sq. ft.) ............ .............
Business name: New bldg.area(sq.ft.) ................................
Addn s: t r, Number of stories
City: State: ZIP: Type of construction.................•..................
Phone: Fax: _ E m I' Occupancy group(s): Existing: —
CCB no. ;t} �/ 7 j �//4 New:=
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
_ :State:
jurisdiction where work is being performed. Ifthe applicant is
PAddress - exempt from licensing,,the following reason applies:
Cit ZIP•Contact person: .:Phone: Fax: •mail:
Name: I , Contact person: +fees due upon application .......................... $
Address: Date received:
-------
City: State: 'LIP: Amount received ............................... ...... _
Phony: Fax �- �, 7 1 F-mail: Please refer to fee schedule.
hereby certify I have read and examined this application and the Nd W jurisdictions accept ctrdit cm please call uda clion fa 1 intomwtion
attached checklist. All1-'ovisions of laws anti ordinances governing this Uvisa fon
t'nedit cud num
work will be complied with�bVher specified herrn or not. 4-
AUtIlOrI7Cd signature:. �� Date: /< t µrlri►ef crAlmMei ex►hewn on urdn card —
$
Print name:
el aitnuure R� i nt
Notice:This permit application expires il'a pemtit is not trotained within 180 days oiler it has heen acccpied ns complete. 4404611 tbva+'oMl
One- and Two-Family Dwelling
Referenceno.:
Building Permit Application Checklist —
Associated permits.
(
I I t ofTigard City of Tigard U Llecim al 'J I'lumhinr i Mechanical
Address: 13125 SW Ball Blvd,Tigard,OR 97223 U Other:
Phone: (503) 639-4171
Fax: (503) 599.1960
Fullr
I Land use actions completed.tier jfit isdIclIon crite Iw IM concurrent re%ic,vs. _---_
%oning.Flood plain,solar balance points,seismic stills designation historic district,etc.
Verltication of approved plat/int. —
t Fire district approval required. —
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit.
7 Water district approval.
9 Soils report.Must carry original appli,'able stamp and signature on file or with application.
9 Erosion control U p6dt U pernit required.Include drainage-way protection.sill fence design and location of
cutch-basin protection,etc.
13_ Complete sets of legible plans.Must he drawn to scale,showing conformance to:+pplicaMe lucid and stair
0
building codes.Lateral design drt;uls and connections must he incorporated into the plans rr()it separate full sirs
sh•et attached to file Plans with cross references between pian location and drl;als. 1'Lu, I • I['" k armor he Completed
if copyright Violation',rxtst —
I I Slte/plat plan drawn to Sim e.'I It J taut must show lol turd huildml,setback dinu•mn)It'.,prnl,ery corner elevations(it
their h,nnirr dun;14-11.clevarn at ditlerential,plan nuts)show contour line at 2 It atlrn ills):location of casrnmrnts and
drisr\s,t\ t M+tprinl of suvctwe(ntrluding decks 1,location of wells/srpo uttlnv I(kauons;direction indicator;lot
arca:111111lou'4���rrage area;percenlage ol'Crvcragc;nulx:rviuus arrc existing unctures(111 silt;and surface drainage.
12 Foundation plait.,Show dimensions,anchor halts,tiny hold-downs and reinforcing pads,connection details,vent
sill'and location. - - – ----- -
13 Floor plans.Show all dimensions,room identification,window sire.lorauon ,f snu,kr detrcfors,water heater,
furnace,ventilation fans,plumbing fixtures.halconirs and decks 30 itches ah-t-uradr,etc.
14 Cross section(s)and detnlls.Show all fr."' nu tither sizes and spacing such as floor proms,benders,trusts,sub-fn. 11s.
wall construction,rout'construction. Moir Ihan one cross section may he reyuircd to cleanly portray construction.
details of all wall and roof sheathing,tooling,fort slope.coling freight,siding marc ml,routings and foundation,s
tier lace constntclion, thermal insulation,etc.
S >Jlevation views.Provide rlevauom 1()l �+ construction:minimum of two rlr�;u�ons for additions and remod
Exterior elevations must reflect flu a. tit.a1 grade it the t h age it,grade is greater than lour foot at building enve
full-size sheet addendum Av-int' lound,(tion cicvaltons with cross references are acreptablr.16Walt bra.^ung(pracrlptive pe�h►andlor lateral anatysls plans.Must indicate details and locations:fur
lion•prescriptive pt,tti analysis provide specifications and calculations to engineering standards,loor/roof framing. rovide plans for all flours/roof assemblies,indicating member sizing.spacing,and hrnri
locations.Show attic ventilation.
19 nasement and retainhrg walls.Provide cross scrtiong,and details showing placement ol'rebar.For enetncrred
systems,ser item 22."G�mgumecr's calculations."
19 Ream calculations.Provide two sets of calculations using current code design values for all beams and multiple Joists
over 10 feet long and/or any heart/joist carrying a non-uniform load.
20 Manufactured floorlroof truss design details.
21 Energy(bde compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When reyuircd or provided.6 r shear wall,r of truss)shall he stamped by an engineer or
architect licensed in Oregon and shall he shoe n to hr al,l,i ,,d,!r to the project under rr,h tr
23 Five(5)site plans are required for Item I 1 above. Site plans must he K-1/2" x I I"or I I" x 17". —
24 Two(2)sets cacti are required for Items 16, Fr,20.E 22 above.
25 Building plans shall not contain red lines or tape ons, "Mirrored"building plans will he not,�cceptrd.
6 " ever " huildin plans,m+st meet criteria outlined in the Permit&System Development Fees document.
f tort or engineer scale.
29 Site plan to include.erre size,type& ovation per approved project street ree plan(if aprlicable),and COT Street Tree List.
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. Ma4614(b'°tvco'd
SEE 35MM
ROLL # 20
FOR
OVERSIZED
DOCUMENT
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received Date Requested �__� __-- AM_--- PM _--- BUP --
I_ouation �✓ 1�O�L NG'� - —- -- -- -Suite MEC —
Contact Person Ph( -) -- --- —--- PLM
Contractor ---
Ph( ) - - _ SWR — ----
--- --�-----�---
BUILDING Tenart/Owner _ ELC
Footing ELC
Foundation Access:
Fig Drain ELR .--_.------.____—__-
Crawl Drain SIT _-_--
Slab Inspection Notes:
Post&Beam -- ---i-
Shear Anchors
Ext Sheath/Shear - - -
Int Shealh/Shear
Framing ------ ---- _--_ _---_ ----
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ( "r ) -� --�------ ---
Fire Alarm
Susp'd CeilingRoot
- ----
--
Other:
F in - -- --
A PART FAIL
-------------
P UMBING
Post&Beam
Under Slab - ----�--- --
Hough-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
Service
Rough-In ---- - --.—
UG/Slab -- T--
Low Voltage - -
Fire Alarm
Final Reinspection fee of$J___-_. -_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL Please Unable to inspect -no accesG
SITE � r•all'or reinspection RE: - --- - -- ---
Fire Suppl! Line
(�'�
ACA ` � 1 �-- Ext------ ..--
Approach/Sidewalk Date------ -= Inspector __-
Other
sinal DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL