Permit CITY OF � BUILDING PERMIT
PERMIT # . : BUP96-0454
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/06/96
1o1omaw Hall Blvd. Tigard, Oregon e7223°819e (503) 639-4171
PARCEL: 1S126DC-01000
SITE ADDRESS...: 09475 SW LEHMANN ST •
SUBDIVISION ^ LEHMANN ACRE TRACT ZONING:R-12 •
BLOCK..........: LOT ...... .......:4
________ _ _ ______ __ _ _
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION-
CLASS OF WORK.:DEM FIRST....: 0 sf N: S: E: W:
TYPE OF USE...:SF SECOND...: 0 sf PROTECT OPENINGS?----------
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP.:R3 TOTAL : 0 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS- REQUIRED -
FLOOR LOAD ^ 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNI}ICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE.$: 0
Remarks: DEMOLITION of existing residential dwelling, detached garage & shed.
Sewer is to be capped and inspected. Debris to be removed ONE lot on
new subdivision to be granted the following credits: 1 Sewer DU, $100 Water
Quantity, Parks $1050, 10 TIF trip credits.
/q7
Owner: --- FEES --------------
HANS HENDGEN type amount by date recpt
15243 NE COUNTRYSIDE DR PRMT $ 25.00 JDA 08/06/96 96-282584
5PCT $ 1.25 JDA 08/06/96 96-282584
AURORA OR 97002
Phone #: 503-678-2282
Contractor: ------ -
TALLON CONSTRUCTION
PO BOC 698
MOLALLA OR 97038 -
Phone #: $ 26.25 TOTAL
Reg #..: 115119
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Cap sewer line _
Tigard Municipal Code State of Ore. Specialty Codes and all other Final Inspection _ __-
applicable laws. Al} 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 work is suspended for more _
than 180 days.
___
Permittee Si nature: �� � • L i , ____
� -� _
Issued By: _^'^ _ ____ __ __
Call for inspection - 639-4175
- - •_ • _-'-
11\= Pak ti-- g W4 (sew-eW) .
Plan Check #
;IY`Y TIGARD Residential Building Permit Application Recd By
3125 SW HALL BLVD. New Construction Additions or Alterations Date Recd
" IGARD, OR 97223 Single Family Detached or Attached Date to P.E.
503) 639 -4171 Date to DST
Print or Type Permit# I "' 0 y�"�
Called
Incomplete or illegible applications will not be accepted
Name of Subdivision Lot # Name
Job
Address Site Address Architect Mailing Address
Name City /State Zip Phone
7 1 t-lc'-AID G& J .
Address Name
Owner Mailing
IS 2' � � N� Cc+cln�'s2Y
e A M A,, i o
Engineer Mailing Address
ity /State Zip Phon g loan r$Gc) ¢- i.►rnI2rvAJ -*/a3
/,�A oQ 70£1 �� -3 City/State Zip Phone
Name T &4i -i2 911-)-3 V,5 "31
General . Tn1 t✓OA)JT l2(1CT %a /J Describe work new 0 addition 0 alteration 0 repair O
Contractor Mailing Address to be done: . c i4 /71
P 0, /,c1... & a' S Additional Description of Work:
C ittyy/State Zip 0703 Phone
Oregon Const. Cont. Board Lic.# Exp. Date
Attach Copy of 1 (57/ 9 7-F Project
Current COT Business Tax or Metro # Exp. Date Valuation
Licenses
Name Sil NEW CONSTRUCTION ONLY:
Mechanical Sq.Ft. House: Sq.Ft.Garage:
S Mailing Address
Contractor Corner Lot Yes No Flag Lot Yes No
City /State Zip Phone (check one) (check one)
Restricted Audio /Stereo Burglar
Oregon Const. Cont. Board Lic.# Exp. Date Energy System Alarm
Attach Copy of
Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC
Licenses Opener Systems
Name (check all that Other:
Plumbing apply)
Sub- Mailing Address Will the electrical subcontractor wire for all Yes No
Contractor restricted energy installations?
City/State Zip Phone
Has the Subdivision Plat recorded? N/A Yes No
Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# Solar Compliance
Attach Copy of - _ - _ - _(Calculation Attached) -- -- - --
-- -- Current - ` ° Plumbing Lit. # • Exp. Date I hereby acknowledge that I have read this application, that the
Licenses information given is correct, that I am the owner or authorized agent of
COT Business Tax or Metro # Exp. Date the ow er, and that plans submitted are in compliance with Oregon
Staty I s.
Name Si a e of 0Aner /Agent it/e&106
j-e-- ` t_x_i.
Electrical
Contact Person Name Phone
Sub- Mailing Address
Contractor FOR OFFICE USE ONLY:
City/State Zip Phone Plat # Map/TL #:
Oregon Const. Cont. Board Lic.# Exp. Date --
Attach Copy of Setbacks Zone: Solar:
Current Electrical Lic. # Exp. Date
Licenses
COT Business Tax or Metro # Exp. Date Engineering Approval: Planning Approval: TIF:
sts \mstapp.doc
V
P_ermit-# _ Account Description - Amount Amt. Pd, Bal. Due
MST. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC /ELR Permit (ELPRMT)
State Tax (TAX)
Bldg:
Plumb:
Mech:
ELC /ELR:
Plan Check
MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
is \dsts\mstapp.doc
Rev. 7/96
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service INAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
n. ew Gas Line Appr /Sdwlk Reins.
Other: - _ � 11-I
Date: 7 (q A.M. M. Entry:
Address: ‹.-.)1
Tenant: Ste: MST:
BUP:
Con /Own: MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: / t�-4/ Date: s !.[a`74
APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION DIVISION 5'14.13 -tea/
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 !�j
OIL/ Date Requested �/ �"� ^ � AM PM BLD c�
Location 9'271 7 5 L : 2 , ,rz1j(7K Sfr Suite MEC
Contact Person ,-t' -rte.. Ph (d) q ,; S PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing nds Access: i' u yLe_,#- ,
,,a '? ( 62,c
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 6°' _
Slab C. --C,P r L� �J Ae'p SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof in
Misc: V21 0
.Y
� Final
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 Z
her a e 7- 4'9 Ext
�Inspector p� E x
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.