Permit /\ CITY OF TIGARD ERMIT #P MST97 -00532
" DEVELOPMENT SERVICES DATE ISSUED: 09/16/1999
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11420 SW 92ND AVE PARCEL: 1 S135DB -03800
SUBDIVISION: DOGWOOD RIDGE ZONING: R -4.5 •
BLOCK: LOT: 011 JURISDICTION: TIG
REMARKS: 392 sq. ft. accessory structure
BUILDING
REISSUE: STORIES: 0 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ACS HEIGHT: 0 FIRST: 0 sf BASEMENT: 0.00 sf LEFT: 0 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 0 SECOND: 0 sf GARAGE: 0 sf FRONT: 0 PARKING SPACES : 0
TYPE OF CONST: 5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT: 0
VALUE: $ 2,530.00
OCCUPANCY GRP: R3 BORM: 0 BATH: 0 TOTAL: 0.00 sf REAR: 0
PLUMBING •
SINKS: 0 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0
LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0
TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: 0 GREASE TRAPS: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN < 100K: 0 BOIL/CMP < 3HP: 0 VENT FANS: 0 CLOTHES DRYER: 0
FURN > =100K: 0 UNIT HEATERS: 0 • HOODS: 0 OTHER UNITS: 0
MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 0 WOODSTOVES: 0 GAS OUTLETS: 0
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 0 - 200 amp: 0 0 - 200 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 EA ADDL BR CIR: 0 SIGNAL/PANEL: 0 IN PLANT: 0
MANU HM /SVC /FDR: 0 601 - 1000 amp: 0 601 +amps- 1000v: 0 MINOR LABEL: 0
1000+ amp /volt : 0
PLAN REVIEW SECTION
Reconnect only: 0
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREAISPC 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: ' DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS: 0
Owner: Contractor: TOTAL FEES: $ 65.46
OWNER This permit is subject to the regulations contained in the
SIGNED RESPONSIBILITY FORM Tigard Municipal Code, State of OR. Specialty Codes and
IN FILE all other applicable laws. All work will be done in
accordance with approved plans. Th is 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 #: 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 Final inspection
Framing Insp Building Final
Misc. Inspection
Misc. Inspection
Misc. Inspection
Issued By : , rif..,r,., Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
c ,. Plan Check .# i2 ��
CITY OF TIGARD Residential Building Permit Application Rec'd By(�
13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd i 'Pi-4 7
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 1Z - 3 •W
V 503 - 639 -4171 Date to DST
F 503 - 684 -7297 Permit #W1S'- q'? -053Z
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Project f� Name
Job D0 1� f
Address Site Add ress Archite Mailing Address
are , / City /State Zip Phone
bl E.PI4An►It✓£ Kevin! Yi,4t.,vE.
Owner Mailing Address Name ,,,
11420 $L4J 92 ^ ' D ' `
City/State Zip Phone Engineer Mailing "Address
/ 4AtQA /O . 97Z _67O --O(d City /State Zip Phone ■
General Name ' l e / f �
Contractor m1 Wt0EL Describe work New ® Addition 0 Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit Additional Description of Work:
issuance, a copy City /State Zip Phone A ct .e ssokw . 6 .7- C - Pt C ATriaC ea t'
of all licenses
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# VALUATION $ 25 30.00
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Add ss
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City/State Zip Phone (check one) X (check one) X
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon- Const. C ont. Board Exp. D ate Energy System Alarm
expired in COT Li
database Installation Garage Door HVAC
Plumbing Name Opener Systems
Sub- (check all that Other:
Contractor Mailing Addy ss 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 Const1Cont. Board\ Exp. Date _
required if Lic.# / Reissue of MST #: 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 Si at Oaaner /Ag`ett Date
Sub- Mailing Address � � ►Z - 1 9'7
Contractor C tact Person Nam Phone #
City /State ip Phone _
Prior to permit OR OFFICE USE ONLY:
issuance, a copy Plat #: Map/TL #:
of all licenses are Oregon Co sf. Conti Exp. Date Nt h, (4, \ 1 i S I � JClL
required if Lic.# �� ��1��« I
expired in COT \,.. Setbacks") Zone:/ _/ J Solar:
database Electrical Lic. # Exp. Date ll/��/' l y(
Engineering Approval: PI nnin Approval: TIF:
leis i oo?-z-
4 , re.. 4:M) , e; ''
— 6w L1) �°
----6a-me. 0 425. 4'3 ( , , .' I:SFREM.DOC (DST) 4/97
. 1 1.9
•
09/16/1999 Activities for Case #: MST97 -00532
2:46:44 PM
Assigned Hold Updated
•
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA005 Application received 12/01/1997 DRA RECD BON 12/03/1997
MSTA008 Permit Created 12/03/1997 B DONE BON 12/03/1997
MSTA010 Check for prcl. restrict. 12/03/1997 B PASS BON 12/03/1997
MSTA012 Plans routed to Plans Examiner 12/03/1997 B SENT BON 12/03/1997
MSTA026 Plans approved by Pln Examiner RB BT2 .09/16/1999
MSTA030 Reviewed plans routed to DSTS 09/16/1999 BT2 DONE BT2 09/16/1999
MSTA032 DST Post - Review Completed BON 12/03/1997
MSTA155 Development conditions met BON 12/03/1997
MSTA705 Footing Insp BON 12/03/1997
MSTA799 Building Final 11/06/1998 RB PEND DGW 09/16/1999 Steel tubing & canvas cover
structure/ property line set -back
, ok/ No further inspections
• needed....May be passed by
' review upon issuance of permit.
MSTA770 Misc. Inspection 11/05/1998 RB RESH RB 11/05/1998 RESEARCH- Made site visit to
notify owners re: MST97 -0532
. & MIS97 -0022 taken out for an
accessory structure 392 ftsq
and 14 -feet high. Asked for
contact regarding these
permits. If structure is already
• constructed, owners need to
pick up plans {after being
approved) and make
arrangements for inspection.
MSTA770 Misc. Inspection 11/05/1998 RB NOTE J *H 11/05/1998 Research inspection and
• contact only.
MSTA725 Framing Insp 11/06/1998 J *H 11/06/1998
MSTA798 Final inspection 01/11/1999 RB PASS RB 01/11/1999 No special instructions given to
owner for construction. Owner
complied with approved plans
and manuf. installation
standards.
MSTA770 Misc. Inspection 01/21/1999 JT 01/21/1999 note to Hap that we finaled but
. permit not issued. bob t.
holding application because of
. engineering. Jeanne
MSTA970 Case Finaled . 01/29/1999 VLN 02/25/1999 Per Rick B. 11/6/98.
MSTA053 Hold Release to Pending Status 09/16/1999 HAP PEND No Hold DGW 09/16/1999 Review of case indicates final
inspection performed and may
be passed by review upon
issuance of permit. (See Final
Bldg Insp by RB)
• Page 1 of 2
09/16/1999 Activities for Case #: MST97 -00532
2:46:44 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA092 (F) Issue combination permit 09/16/1999 - SHER DONE No Hold GEO 09/16/1999
•
Page 2 of 2
CITY OF TIGARD BUILDING INSPECTION DIVISION &P
MST 53
24 -Hour Inspection Line: 639 -4175 Business Line: 6394171
BUP
Date Requested ' I c `n AM PM BLD
Location i I "'1 a---0 04 Suite MEC
Contact Person Ph PLM
Co A l l r Ph SWR
'BM G Tenant/Owner ELC
Re . ining Wall ELR
Footing
Foundation ( FPS
Ftg Drain I NOT REQUESTED I SGN
Crawl Drain f\--C
FOUND D URING RESEARCH / SIT
Slab
Post & Beam I NO INSPECTION(S) IN FILE t T-7 a �,�
Ext Sheath /Shear l 1 s
Ina mingth /Shear s ( C i --
Framing
Insulation I I. / I
Drywall Nailing
Firewall p �'
Fire Sprinkler �� �_ 1_.s ,a
!,/ -4 rt / G
Fire Alarm / 4
Susp'd Ceiling �-.� ..- . _ ` — Q
Roof � � / yf
Misc: ._ A / 2 .
/ / / - jXJ (. 2 /LCi Y-1 Qj
Final '" '
`
�
PASS PART : ` - - 5 .. k
PLUMBING (* / 11 /;, �� .
Post & Bea
Under Slab
5 1 s i /� 0 , L1/'\D . S (.,e-T1 *Z.1.-* Top Out
Water Service l/N" '�� \ \ 1
Sanitary Drains Sewer ( I O Rain Drains �
Final 1 •
PASS PART FAIL S+ . / w-- \- V\. •
MECHANICAL
Post & Beam J c ((��
Rough In "� \' �/1/�, 1/V l�'\/�( 0...E-Z...S.g
Gas Line
Smoke Dampers 1/\/Q, _ �.b `c ? S .
Final �
PASS PART FAIL f C9......-42...
ELECTRICAL �� 4 ��
Service 't� �� l.l s,( Q,21 3 '
Rough In
UG /Slab
Low Voltage .�7( � .-- /fit 7 I 3 / ( I
Fire Alarm
\11
f c `�
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk t /�
Other Date \ " I Inspector / E) 1,
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Q 7 oc3 �. 41, 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 /Qin AM PM BLD
Location \ \, 4- ' i Z t Suite MEC
Contact Person Ph PLM
Co.ntrac or Ph SWR
ILDI Tenant/Owner ELC
Re aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: \1 .-rc�
SIT
Post & Beam n^ --
Ext Sheath /Shear - 1 v 97 - ®e 2. 2-
Int Sheath /Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
• Miser
8 44 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 V(9.1K
Other Date � I nspector Ext J
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •