Permit ., CITY OF TIGARD MASTER PERMIT
i�,, DEVELOPMENT SERVICES PERMIT # - MST97 -0571
:^ . re lf'._. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: i `l26/S7
PARCEL: E5115BA -02400
SITE ADDRESS•..:12000 SW KING JAMES PL
SUBDIVISION • ZONING:
BLOCK LOT • JURISDICTION: KIN
Remarks: Enclosing patio - Non Habital area - Use intended to be a wind break only.
walls will be open at the top
— -___ —_ ---------------------- BUILDING --- ------ ---- -- ----------- _ ---- ----
REISSUE: STORIES • 1 FLOOR AREAS - ---- BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED----- -
CLASS OF WORK.:ALT HEIGHT • 8 FIRST • 150 sf. GARAGE 0 sf LEFT. • 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD : 0 SECOND...: 0 sf FRONT : 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT : 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL : 150 sf VALUE..$: 1>Yi REAR • 0
-- - - — - - ----- - PLUMBING -- -- -- -- --- ----- ------ -----------
SINKS : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS : 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
- -- ----------------- - -- MECHANICAL --- -- ------------ --- —
FUEL TYPES -- FURN (100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS : 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 0
____ __ —_ -- — - _— ----------- ELECTRICAL ---- -- --_ -- --- _
-- RESIDENTIAL UNIT— — SERVICE /FEEDER --- - -TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — ---- MISCELLANEOUS -- - -ADD'L INSPECTIONS -
1m 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 alp..: 0 401 - 6Y amp..: 0 EA ADDL BR.CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HM /SVC /FDR: 0 601 - 1000 amp.: 0. 601 +amps- i■Y, v: 0 MINOR LABEL -10: 0
1M+ ampivalt.: 0 --------------------- ---- -- PLAN REVIEW SECTION ---- -- --
Reconnect only.: 0 )=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..: DTH: .. BOILER HVAC • LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: ••
HVAC DATA /TELE COMM.: NURSE CALLS....: TOTAL 0 SYSTEMS: 0
Owner: -- -----------------------Contractor: - -- ---- TOTAL FEES:$ 42.50
PAUL WILSON OWNER This permit is subject to the regulations contained in the
12000 SW KING JAMES PL Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: 639 -4648 Phone 0: not started within 180 days of issuance, or if the work is
Reg 0..: ',:∎:, 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 - -0010 through OAR 952- 001 -: You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
- -- - - - - -- - - — --- REQUIRED INSPECTIONS ---- -- ---- -- -- - - -- -
Framing Insp •
Building Final ,."'"
Issued By: ,---, 40!2/ F'ermittee Signat�_:re:�G $ 1,521, —
+ + + + + + + + + + + + + + + + + + + + ++ .++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + ++ + + + + ++
Call 639 -4175 by 7:00 p.m for an inspection needed the next business day
Plan Check ,-. -44 "
CITY OF. TIGARD Residential Building Permit Application Recd By -
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd M ;) '/ -
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 17-
V 503 - 639 -4171 Date to DST iZa"' ".4'Ur
F 503- 684 -7297 Permit #0 14511 7 -- O 5 7/
Print or Type Called _ ' /6 /7-•
Incomplete or illegible applications will not be accepted j (c (0-1..
Name of Project ("tl Name
Job L- dG/e7S g PA", 0 -- efic 6lw L Architect Mailing Address
Address Site Address >
/24000 /i/ ;(J f /l G S pi, City /State Ziri Phone
Name
/ P® ®R /iLt`7 7 M.s i 1
Name
Owner Mailing Address 0
/ ', /V 17-7"/ Engineer Mailing dr ss
City/State Zip Phone g
x%
General Nam LJ � I � 72z ,/ �i,�/- � G�� City /State Zip Phone
Contractor /DA , 6 Lo/c6o,)� Describe work NewO AdditionO AlterationO RepairO
Mailing Address to be done:
Prior to permit �} Additional Description of Work: '
issuance, a copy City/State ejip \ Phone
of all licenses i.,
are required if Oregon Const. nt. Board Exp. Date PROJECT /P
expired in COT' Lic.# \ VALUATION $ / 0 ® 0 e
database /
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- 7 S q . Ft..House: Sq. Ft. Garage
Contractor Mailing Addres ��
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City /State Zip Phone (check one) (check one)
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon Co st. Cont. Board Exp. Date Energy System Alarm
expired oT Lic.# ataba e 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. ortoard 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 ture o wrrier /A ent Date
Sub- Mailing Address �( ' (A . I4, i �., 2 "- /.2 -di/4
a1 / -.
Contractor Contact Person Name Phone #
City/State i Phone 6 3 / -
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat - : ( Map/TL #: ,�,x
of all licenses are Oregon Const\ . Board Exp. Date Gjl 15
required if Lic.#
expired in COT , r b- ks: Zone: 0 , ‘ „,..
Solar: /ii
database Electrical Lic. # Exp. Date
nn } ' g. Appro , al: _ _ PlannivIA val: - - -- -TI '.v
V
� 00
�,a5 • I:SFREM.DOC (DST) 4/97
IA/ KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
® Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -=1171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: �� C rr SGt '
(
located at: an /y:1 5u) ?'rni .GLvt[i.0
61,0 (.4_, \UO-4-
King City Representative
- -- - -__ - - - - - - - _ 1 , DSTSKCIN'SI.DOC - _ - - - -- - -- --
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(I CITY OF TIGARD BUILDING INSPECTION DIVISION .
I / 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
' 7
Date Requested: q 3 -30 ^ ?O A.A.M. P.M. MST: / -c2 ` / 7
/
Location: 1,,.1100 () ,16/1 BUP:
Tenant: Suite:. Bldg: MEC:
Contractor: s Phone: PLM: ci
Owner: ,t, ( f �2 n Phone: �,• 3 I ` � ELC:
• ✓ ,, /C�//)'■_) ELR:
Ynade c .QCJ7 Th SIT:
BUILDING • ,r(LDGJ��eon't) PLUMBING MECHANICAL ELECTRICAL SITE
Site PosgReam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof 7 UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out . Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /AIm Crawl/Found Dr Heat Pump Low Volt
ice, ,Approve Approved Approved Approved Approved
Appr /Sdwlk o A roved Not Approved Not Approved Not Approved Not Approved
FINAL • FINAL FINAL FINAL
- L',Q 4.i L 1G lj- 4 .:::ei A / 4..i L 6)C'e'Z(C oft, 3o 2, 2 \.�.'1`S
•
-- - - - - -O -Call- for - reinspectio — -- C- Reinspection- fee- of -$ - -- — required- before - next-inspection ------ - - - -O- Unable -to- inspect----- - - - - --
Inspector: Date: ' -'� - -. f Page of