Permit CITY OF TIGARD MASTER PERMIT
ktk PERMIT #: MST1999 -00245
�i14 DEVELOPMENT SERVICES 1 DATE ISSUED: 7/27/99
'� 13125 SW Hall Blvd., Tigard, OR 97223 0113 11/4
SITE ADDRESS: 11435 SW 92ND AVE PARCEL: 1S135DB -04700 .
SUBDIVISION: DOGWOOD RIDGE . ZONING: R -4.5
BLOCK: LOT: 007 • JURISDICTION: TIG
REMARKS: adding Family room and patio
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 10 FIRST: 162 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : .
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $ 13,094.58
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: sf REAR: 15
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 413.51
GAVETT, WESTON C + KERRY L DOUG RIPLEY This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes and
11435 SW 92ND AVE 3324 SW BEACH AVE all other applicable laws. All work will be done in
TIGARD, OR 97223 LINCOLN CITY, OR 97367 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
Reg #: LIC 36437 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Footing Insp Framing Insp Electrical Final
Slab Insp Shear Wall lnsp Final inspection
Underfloor insulation Low Voltage Building Final .
Electrical Service Insulation Insp
Electrical Rough In Rain drain Insp
Issued
/.s1 P. 4./_____ Permittee Signature : ��� �' k"./(1-
� `
' �- -
CaII (503) 639 -4175 by 7:00 p.m. for an inspection needed the next bu ess day
Plan Che 7- 9
CITY OF TIGARD Residential Building Permit Application Rec'd By
13.125 13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd 7-6 `f9
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 7 - /.- -4
I V 503- 639 -4171 ' Date to DST 7-M7 - rr'
F 5 0 3 - 6 8 4 - 7 2 9 7 31_1_____ 1 - - Permit # / 1 ' t 9 - 0 (i S'
Print or Type Called 9 - 94 ? —�—
Incomplete or illegible applications will not be accepted
4Fr Vr1fi' _ bz'59-
Name of Project Name
ell
Job Farm I I Zoovn aoli-ti "To ias-For1
y Archite Mailing Address
Address
Site Address 9S( SW 094-h Ad e,
I1436 Sk ) 6 1Z1 4 0 Ti 5arci 9/ Z13 City/SS Zip Phone
Name e 'PO ("land o Q c7Z Z ,24G - $ , 1'71-
Kervk ss GS &a..of,t Name
I
Owner Mailing Add
t 1435 SW 92ND. ' "',%. '' Engineer Mailing Address
City/State Zip ' 4 Phorie g
/ 1cA.(4 b2 ?22 3 6.24 --71 K City/State Zip Phone
General N e . •
Contractor f '
l�o U 1 i C �J Describe work New 0 Addition` Alteration 0 Repair 0
Mailing Address ( to be done:
Prior to permit 3 3 a 4 SW eG pGl, Avg Additional Description of Work: I // �� h
issuance, a copy City/State Zip Phone eSa3) A01o11 r13 a 1203 sc� Ai- 4o ( h't roe ter►
of all licenses Lir)cc )fr- Ci ®(� 91367 aq1 - 341
are required if Oregon Const. c ont. Board Exp. Date PROJECT
expired in COT Lic.# 0 3 6 4 S1 41- / b o b VALUATION $ / 3 , 94
database s /
•
Mechanical Name q-0.-60 NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: • Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City/State Zip Phone (check one) (check
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarm
expired in COT Lic.#
database Installation Garage Door HVAC
Plumbing Name Opener Systems
Sub (check all that Other:
Contractor Mailing Address apply)
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A YES NO
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Electrical OL o 1e2{ — tAi es G Signature of Owner /Agent Date .
S Mailing Address - � �j d (� — 1/ 67 rig
Contractor Contact rsor' Name _ Phone #
City/State Zip Phone K e ry Csa Ve I I VQ1- -7I gD
Prior to permit FOR OFFICE USE ONLY: (,)
issuance, a copy Plat #: Map/TL #:
of all licenses are Oregon Const. Cont. Board Exp. Date /6 / 3 S - D6-6V - 70 0
• required if Lic.# Setbacks: Zone: - ,..3 t--- Solar:
. expired in COT
database Electrical Lic. # Exp. Date Engineering Approval: Planning Approval: TIF:
A �
1 I / �' • I:SFREM.DOC (DST) 4/97
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11435 S.W. 92 AvE. I I " <I[
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CITY OF TIGARD (N\
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� � N OS' S8' W — — /
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SITE PLAN
1 i = 20' -0"
; i
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
OWNER
•
Electrical Signature Form
Permit #: MST1999 -00245
Date Issued: 7/27/99
Parcel: 1 S135DB -04700
Site Address: 11435 SW 92ND AVE
Subdivision: DOGWOOD RIDGE
Block: Lot: 007
Jurisdiction: TIG
Zoning: R-4.5
Remarks: adding Family room and patio
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
GAVETT, WESTON C + KERRY L OWNER
11435 SW 92ND AVE
TIGARD, OR 97223
Phone #: Phone #:
Reg #:
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X 40.
Signature o u ervisin Electrician
g P 9
If you have any questions, please call (503) 639 -4171, ext. # 310
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hour Inspection Line:. 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM -PM BLD
Location /II uite . MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING . Tenan air= C4AALe..., & , 6 �' ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain `
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam „ ®
Ext Sheath /Shear r4 .C.�/.1� /.,1�''
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL A/04"' c. A__P '�;�' /'��
PLUMBING t j /�1'��iSS ✓ 7
Post & Beam
Under Slab / — pp lop Out /,. � / Water Service
6 ; ! •` �' T __ Yr-v i C,49
Sanitary Sewer
Rain Drains -
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PART - IL
E ECT ICAL
e -
Rough In
UG /Slab
Low Voltage
Fi -alarm
S S - ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspecti•n RE: [ ] Unable to inspect - no access
ADA -
Approach /Sidewalk ?
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST / q'q -go 2 / •�
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
[o
Date Requested .29 -00 AM PM \ BLD
Location j Ajg " ' Alv Suite MEC
Contact Person KA, ►z4 Ph - y 2 /8 0 PLM
Contractor • Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation • FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT •
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing Ec / "(--/ 4 - 4 CG_ i? �>
Insulation //
Drywall Nailing ''tee = At? . " O`Ze"
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
a i r PART FAIL
PLUMBING •
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other Date - - 9 - "g Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.