Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST1999 -00253
, �i �, DEVELOPMENT SERVICES DATE ISSUED: 8/3/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13617 SW 121ST AVE PARCEL: 2S103CC -05300
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: J URISDICTION: TIG
REMARKS: 371 square foot addition to garage. \cl\\'\
BUILDII \
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 10 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: N
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 371 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 6,930.28
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: BOIL/CMP < 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 FOR: 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: SIGNAL/PANEL: 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: $ 271.58
JOHN A + CAROL L TABOR VIEW REMODELING INC This permit is subject to the regulations contained in the
STOTLER, JO
STOTLER, ER 1 N 1253 SE 71ST Tigard Municipal Code, State of OR. Specialty Codes and
13617 SW
TIGARD, OR 9 H T AVE A PORTLAND, OR 97215 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 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 106033 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 lnsp Electrical Final
Slab lnsp Final inspection
Electrical Service
Electrical Rough In
Framing I
• J ill Is ed By : J _ 4 I 1_ , ' '.� • Permittee Signature I I / :i
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
r TY OF TIGARD Residential Building Permit Application Plan cne 125 SW HALL BLVD. Additions or Alterations Recd B . GARD, OR 97223 Sin le Famil Detached or Attached Du lex Date Recd 7 /(y -9 9 y t p Date to P.E. 7 -/ - 4 9
503 - 639 -4171 Date to DST 9- 7 7 - C
F 503 -684 -7297 ^ _ Permit# M.54/ 9- 0 253
Print or Type I ( called 7 36 99 a
Incomplete or illegible applications will not e - cepted C7 I/ M.
Name of Project Pr J Wa ' Name
Job S -4dgel/' 02s ide -n c-e.
Architect M ailing Address --- /
Address Site Address
k3@? s.c4. 1 21-C r / ,t� ca-Id l cr).
Name City /State Zip Phone
10 5TU T LE ) Name
Owner Mailing Address
13 (P /7 S. W- )a 1 S' - Engineer Mailing Address
Cit /State Zip Phone g
t tu 9 7 2 23 5,o - /o7 I City /State Zip Phone
General 7 - fi tJ /e i O 4' 2 -Tdc
Contractor c 4 0/0( A/4--7-45.04C Describe work New 0 Addition 0 Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit /..A5 ,s 7/ . Additional Description of Work: S7/ 0 4p,-7-70,0 76
issuance, a copy Ci /Stat Zip Phone � - Z4 - C `--
of all licenses r)L TV. 6 a5a -6737 y �o
are required if Oregon Const. ont. Board Exp. Date PROJECT
—
expired in COT Lic.# VALUATION
database Name / /��
Mechanical e A - 10(003.3 4b NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address 37/
Prior to permit Indicate the restricted energy installation by the electrical
issuance, a copy City /State Zip Phone subcontractor in the following areas
of all licenses Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms _
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing Name (check all that Other:
Sub- apply)
Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO
(check one) (check one)
. Has the Subdivision Plat recorded? N/A i YES NO
Prior to permit City /State Zip Phone
1
issuance, a copy
of all licenses are Oregon Con . ont. Board Exp. Date
required if Lic.# I heart acknowledge that I have read this application, that the
expired in COT y 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 _piggatu of O er /Age t Dat
Electrical ID u; ��' c` // — D 7r�
Sub- Mailing Address
4 ct P$�e h o rk # 3
al../ R5 / 7
Contractor ■
City /State Zip - Phone 1 40 "a 3
Prior to permit /-
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: MapITL #:
required if Lic.# ,,//
expired in COT X5/d 3 etg_ oebn D
database Electrical Lic. # Exp. Date Setbacks: - Zone: n , 7 - Solar:
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning /(--
TIF:
/3c.4 Pr t_ 1 . /6 i:\dsts \forms\sfaddalt.doc 11/20/98