Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST1999 -00403
, i i �, DEVELOPMENT SERVICES DATE ISSUED: 12/23/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16500 SW KING CHARLES AVE . PARCEL: 2S115BC -04900
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
REMARKS: Remodel existing dwelling, (bath, kitchen, closets).
BUILDING .
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 2,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: sf REAR:
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PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 2 CLOTHES DRYER:
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1
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: 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: $ 312.80
IRENE GOLDSMITH SHADLE & OMUNDSON INC This permit is subject to the regulations contained in the
Tigard Municipal Code, State work will l Specialty be d Codes and
n
KING CITY, OR 97224 KING CITY, OR 97224 all other applicable laws. All wok will b 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 128509 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 ORIGINAL
PLM /Underfloor Mechanical Final
Mechanical Insp Plumb Final
Plumb Top Out Final inspection
Electrical Service
Gas Line Insp
Issued B : . .� / / /�L— ' Permittee Signature • -4 A.. A 1 'I i , A 4
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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CIT 'OF TIGARD - Residential Building Permit Application Plan Che a — 74
13125 SW HALL BLVD. Alteration - Interior Only Rec'd B Of) _
Date Rec'd /9 4 �
,
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. R - /S
V 503 - 639 -4171 Date to DST /2
F 503 - 684 -7297 Permit # ,* F! 1Qq- &k23
Print or Type Called `�oo" o,
Incomplete or illegible applications will not be accepted /� '13
Name of Project ame
Job / A
Architect icrt t Mailing Address oiho m
Site Addr rcc
I Address � �D l rv'l'o{�'ln)
(.4560 4 N( � ( 5 G � ;
.J�e cy, City /State Zip Phone
r _rrke in cst,,to Ed 65m nil
Owner Mailing Address Name
ID witi ' E n Engineer
Mailing Address
• City/State Zip Phone g
` 50 City /State Zip Phone
General Name '(M 0 MO Ci! - ?J
Contractor 9 tlliti`�► O'@V 1 U NiU0 IN C Describe work New 0 Addition 0 Alteration 4 Repair 0
Mailin Addres} �) to be done:
Prior to permit (n6t W ) Additional Description of Work: � ,-/
issuance, a copy City /State P e c� l �t✓ i Z.tin S/Y� (�1� P
of all licenses 0 ri cl p Li bv --', ) /6 O®0 . C78 are required if r egon Const. ont. Board ' Exp. Date PROJECT
expired in COT Lic.# L !
database ° q �-} ► �' t� a VALUATION
Mechanical Name , � ,p) NEW CONSTRUCTION ONLY:
Sub G-I N - re R. u" r lffiN PAC /A1 /L Sq. Ft. House: Sq. Ft. Garage •
Contractor Mailing ddre s
Prior to permit a-2- -1 to VU g( '('4- e/ Indicate the restricted energy installation by the electrical
issuance, a copy >Yity /State /� Phone subcontractor in the following areas
of all licenses K "r) t 7 1._ 7 � ) Restricted Audio /Stereo ,
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# 1 67 7 , 3 Installations Vacuum Irrigation
database �/ System _ System
Plumbing Name / J (check all that Other: •
Sub- R.O(i apply)
Contractor ailing Address Corner Lot YES NO Flag Lot YES NO
5 )a e�fij K }�, 1 cI 5 • (check one) (check one)
l Q �l ( >� I�1 Has the Subdivision Plat recorded? N/A YES NO
Prior to permit �iZjr/,$�ke � t i p � Phone 4I
issuance, a copy 1, '� / / ' ! Solar Compliance
of all licenses are Oregon Const. Cont. Board Exp. Date (Calculation Attached)
required if Lic.# g /�
expired in COT 7 4' 19 7 I hearby acknowledge that I have read this application, that the
database Plumbing Lic. # Exp. Date information given is correct, that I am the owner or authorized agent
2 ,1 _ 7c P U of the owner, and that plans submitted are in compliance with
od , Ore on State laws.
Name ature of O n en I Dat I q
"/
Electrical 0r,,;T(Rl 1
Sub- Mailing Address
Co ntact ri � s n am �n / l p I ��
b P n #
''
Contractor 177 N-f 41-4 5T, FOR OFFICE USE ONLY: IV
City /State Zip Phone 3 Plat #: Map/TL #:
Prior to permit I� t , o A li n u4 (, P 1 1 /I �� �� /
issuance, a copy Setbacks: Zone: Solar:
of all licenses are Oregon Const. Cont. Board E p. Date
required if Lic.#
expired in COT 01) 1 7 OWN Engineering Approval: Planning Approval: TIF:
database Electrical Lic. # Exp Date
Electrical S pervisor Lic. # Exp. pater_ -6,11),06,0
&:� > ' 3 -106- 0/I /t / . go ,• �� /
i:forms\sfintalt.doc (DST) 10/23/98
CITY OF TIGARD BUILDING INSPECTION DIVISION l �l9 - "OD �b
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 442310
BUP
go Requested 3/ 7/(Y) AM PM BLD
Location 1 56 CO i Y 1 ' Suite MEC
Contact Person 1 I Ph %9 34'S 4 PLM
Contractor Ph SWR
Bt11LDIN:P: ; : ° • pp 7, g !a, Tenant/Owner ELC
Retaining Wall ELR
Footing Access: '
Foundation 6YV FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 0149 P�
Slab f / SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
��}
�." 'UMBI - ')
Post -& beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PART FAIL
ECHANICAL
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk � ---
Other Date A ► Inspector Ext ?`/.
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Ms R 9 63
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested g/ 7 t C AM PM BLD
Location 1Co Sob ' C4"\a/ LL Suite MEC
Contact Person IY / I • Ph 9 (i l _3Y c 2 PLM
Contractor 6 k �l -/ e -(--a^i�1 Ph 1 4 . 7 Z- ,S7�ra SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation V � FPS
Ftg Drain
Crawl Drain Inspection Notes: 15 f f / ldc n „a non„ SGN
Slab l f / + 1. SIT
Post & Beam ��
Ext Sheath /Shear LI i'4 ., C.„_/ el c -G.7s
Int Sheath /Shear '
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS 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
C?I�I'CAC��
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
in
AS 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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 3-7- ac' Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Cms.T /q9q_c:x> y 63
24 -Hour Inspection Line: 639 -41 Business Line: 639 -4171
BUP
Date Requested 3/7/stiO AM PM BL
Location /ice 13 ) ( -040AL14 Suite ME 2 00 —WOO
Contact Person (ci An Ph W1 ? PLM
Contractor Ph SWR
ILDI'il Tenant/Owner ELC
all ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: J ,^ .6'./.0.4 SGN
ri /
Slab P. L.�� � SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling
Roof
Misc:
i
'� PART FAIL
• I "' = ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains (-"�
. Final 1
PASS PART FAIL
C � ....{
Pos m ` 6,
Rough Lil r
Gas s ne e l�" , ��
Smoke Dampers
l, PART FAIL
RICAL
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / � -
Approach /Sidewalk � Date 3 ( 1 Inspector Ext •
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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