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Permit ' 1 --- CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP96 -00503 `,. '�� DEVEL R9 I l 639 -4171 DATE ISSUED: 10/11/96 - 13125 S PARCEL: 2S110CD -07000 SITE ADDRESS: 12010 SW QUEEN ELIZABETH ST SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: 040 JURISDICTION: KIN REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 0 sf N: S: E: W: TYPE OF USE: SF SECOND: 0 sf PROJECT OPENINGS? TYPE OF CONST: 5N 0 sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 0 BASEMENT: 0 sf AREA SEP. RATED: STOR: 1 HT: 12 ft GARAGE: 0 sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: 40 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET: DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM : HNDICP ACC: BEDRMS:0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE: $ 4,000.00 Remarks: enclose existing covered patios (2 walls) Owner: Contractor: BRAZEN CONSTRUCTION MARK GLEN PETERSON 21313 NE 115TH ST Phone: BRSH e PRAIRIE, WA 98606 on Reg #: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT BON 10/11/96 $44.50 96- 285091 Insulation Insp Misc. Inspection 5PCT BON 10/11/96 $2.23 96- 285091 PLCK TAT 9/17/96 $28.93 KING CITY PRMT CTR 4/6/01 $62.50 27200100000 (additional fees not listed here) Total $143.16 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable law. 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 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987. Pen Signature: • //� Signaur .S' �___,ZIA Issued : y: • , ;il , ' dr < /14-g _ Call 639 -4175 by 7 p.m. for an inspection the next business day BUP - Building Permit EL C - Electrical Permit J Inspection Description Date Passed By 1 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 1 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing At Inspection Description Date Passed By Suspended ceiling Post/beam mechanical Engineered soils Gas line Welding Lab Final Mechanical rough -in Concrete Lab Final Fire damper Duct work Bolting Lab Final Smoke detector Fireproofmg Lab Final Mechanical final Structural observation Final inspection 4/10/0 PLM - Plumbing Permit Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit _ Sanitary sewer J Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils / Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS CITY OF TIGARD ,, //9„.„,,, �� (-A DEVELOPMENT SERVICES BUILDING PERMIT .. J. "'� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 PERMIT # • BUP96 —'503 t T TE E Q I I SSUED: 10/11/96 FPARG�I� CD- 07000 SITE ADDRESS...: 12010 SW QUEEN ELIZABETH ST SUBDIVISION • ZONING: BLOCK • LOT • ' REISSUE: FLOOR AREAS -- -- EXTERIOR WALL CONSTRUCTION — CLASS OF WORK.:ALT 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.: 1 HT: 12 ft GARAGE...: 0 sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REDD SETBACKS REQUIRED FLOOR LOAD : 40 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..: DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 4000 Remarks: enclose existing covered patios (2 walls) Owner: FEES EMIL WIRKLAN type amount by date recpt 12010 SW QUEEN ELIZABETH PRMT $ 44.50 B 10/11/96 96- 285091 SPCT $ 2.23 B 10/11/96 96- 285091 KING CITY OR 97224 PLCK $ 28.93 TAT 09/17/96 KING CITY Phone #: Contractor: BRAZEN CONSTRUCTION MARK GLEN PETERSON 21313 NE 115TH ST BRUSH PRAIRIE WA 98606 Phone #: $ 75.66 TOTAL Reg #..: 111638 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Insulation Ins p applicable laws. All work will be done in accordance with Gyp Board Insp approved plans. This permit will expire if work is not started Rain drain Insp within 180 days of issuance, or if work is suspended for more Final I n s p e c t i o n than 180 days. Permittee Si nature: Issued By: gi� (n/ Call for inspection — 639 -4175 Plan Check # CITY OF TIGARD Residential Building Permit Application Recd By I. 'ale" 13125 SW'HALL BLVD. New Construction Additions or Alterations Date Recd _ 141 - 9 49 TIGARD, OR 97223 Single Family Detached or Attached to P.E. (503) 639 -4171 )070rn& -to- - — Print or Type Permit # gl1P% -0'03 .� Called k g:5S <10/ Incomplete or illegible applications will not be accepte " . , Name of Subdivision Lot # Name rV� Job K144 Cry 7 Address Site Addr ss Architect Mailing Address Name City /State Zip Phone /402- $ No., EA c. oh/La .( Name Owner I Mailing Address / 24/0 .4s w 4v.Ezzy 6,7 L/Za4E77-1 Engineer Mailing Address City/State Zip Phone ; IG ✓Gj C...ry c, 6`03 - Gro - 7957 City/State Zip Phone Name . I General ,,¢a goniyriu,,,c.rroA/ Describe work new 0 addition 0 alteration 0 repair 0 Contractor Mailing Address j!o be done: 2/3/3 MY. //5 s r. Additional Description of Work: +r Enclose e ii €o► patio -e t••'�''I , Ecl City/State Zip Phone 5 ,B srf / cda - V 640 6 19 - 2s4 - 1 0739 lis • Oregon Const. Cont. Board Lic.# Exp. Date Attach Copy of ii/ <3k 4/97 Project $ Qv Current COT Business Tax or Metro # I Exp. Date Valuation Licenses Name >�8 4'7S - NEW CONSTRUCTION D UCTION ONLY: Mechanical ; Sq.Ft. House: Sq.Ft.Garage: Sub- i 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 i Opener Systems Name (check all that Other: Plumbing apply) Sub- Mailing Address Will the electrical subcontractor wire for all Yes I No restricted energy installations? Contractor Has the Subdivision Plat recorded? ( N/A Yes I No C4/State Zip Pone I l 1 Oregon Const. Cont. Board Lic.* Exp. Date Reissue of MST# Solar Compliance Attach Copy of (Calculation Attached) Current Plumbing Lic. # ' 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 owner, and that plans submitted are in compliance with Oregon State laws. Name • Si • nature of Owner /Agent D to Electrical . tact ••rso , "ame Phone Sub- Mailing Address l'rn.,,K . - }p , 3&o sikt,„7S Contractor FOR OFFICE USE ONLY: City/State Zip [one Ph Plat # Map/TL #: • Oregon Const. Cont. Board Lic.# Exp. Date A<Y (II] AS I /0 CO- Ono° Attach Copy of Setbacks / Zone: , / Current Electrical Lic. # Exp. Date ( /// Licenses COT Business Tax or Metro # Exp. Date Engineering Approval: Planning Approval: TIF: • •.dstsrrnstapp.doc Permit # Account Description Amount Amt. Pd. Bal. Due R641:445o_3MST. Permit (BUILD) viii-150 W Plumb. Permit (PLUMB) Mech. Permit (MECH) ELC /ELR Permit (ELPRMT) State Tax (TAX) ✓ Z A 3 A. a 5 Bldg: AP 4- 3 Plumb: Mech: ELC /ELR: Plan Check MST: (BUPPLN) ,/ a7, 93 G26,,93 Plumb: (PLMPLN) Mech: (MECPLN) CDC Review (LANDUS) Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (T(F -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: 75 (D 2 gq $7) i:\dsts\mstapp.doc t� / Rev. 7/96 •��� 02/22/2001 Activities for Case #: BUP96 -00503 4:20:05 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes BUPA008 Permit created 09/18/1996 TAT PEND BON 09/20/1996 BUPA010 Check for prcl..restrict. 09/17/1996 TAT 09/17/1996 BUPA015 Routed to Plans Examiner 09/20/1996 B PEND BON 09/20/1996 BUPA020 Plans checked/approved by PE 10/02/1996 RT PASS BT2 10/02/1996 BUPA025 Reviewed plans routed to DSTs 10/02/1996 RT PASS BT2 10/02/1996 BUPA028 DST Post - Review Complete 10/09/1996 DRA PASS DRA 10/09/1996 BUPA725 Framing Insp 12/13/1996 KS DIS KBS 12/13/1996 #-1- renail ext siding ( loose) spots #-2- insulate under mud sill #-3- if ceiling is insulated vent each rafter space and furr rafters to allow air space min' one inch BUPA740 Insulation Insp 05/07/1997 GL PASS KAS 05/08/1997 SEAL AROUND WINDOWS AND DOORS. OK TO DRYWALL & MUD & TAPE (SMALL JOB)' CALL FOR FINAL WHEN COMPLETE. BUPA745 Gyp Board Insp - TAT 09/17/1996 BUPA755 Rain drain Insp TAT 09/17/1996 BUPA799 Final Inspection VLN 09/18/1998 Inspection request for research to Hap W. 9/18/98. BUPA007 Application received 09/17/1996 TAT RECD DRA 10/09/1996 BUPA080 (F) Ready to issue 10109/1996 DRA PASS DRA 10/09/1996 BUPA090 (F) issue building permit 10/11/1996 B PASS BON 10/11/1996 BUPA700 Framing Insp 04/25/1997 KS PASS RDP 02/22/2001 BUPA800 Misc. Inspection 11/18/1998 KS NOTE J *H 11/18/1998 Attached not to door for request to contact inspection request line. BUPA150 Expired by limitation 04 /17/2000 HAP DONE No Hold AKJ 04/17/2000 • Page 1 of ,1 kc CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /Flr /Slab Plbg. Top Out Insulatio ► - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: Date: 5 l 7 I ' ?') A.M. /� P.M. Entry: Address: / ?-G / Q • _� Tenant: Ste: MST: BUP: `o /Own: 3( to MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: - 5 6041 per ✓H 0( KJrKd arll I om�s 6'I( +o 66- / et if T mud ,I- -/e_ 6r l ) D� Ca,11 6 p :exec' 1.J he CaAl (r's(C Inspector: • e a Date: S TV !A PPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO 45 1 olcel CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceilin - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /FIr /Slab Plbg. Top Out nsulation - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: q Date: l 2_ -13 - `7'C., ( A.M. P.M. Entry: Address: _ all JO A. - . mac 1 - Ge j F Tenant: Ste: MST: - BUP: Con /Own: k PL k.-.) MEC: /� 2-00 P,7 (p - ELC: THE F LT -4 " � E�CTJ�NS C UIR J I L cZ AP - 6 -'° G 1 X?" c - Li i .4-C, , lcaDS'r: CWQ_ �f �,.. /!4o:C_(] 1 ei6L/7 - AziJ4LT�!.V erg) /f C1 ,-S-/5' liter' >2.A-7 7 A/ ,_� 'r744-7 nEr�elfi 5.--#4-. z �/�l�G -Td41 ,__, b/u �r�s� o die largo / A-tSU L el -ri d by e-» 77,,, arc- » , € . e , , Inspector: ' Date: /Zg,6 l _APPROVED uiSANPROVED /CALL F0 CF CO CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 96 -6r.5 Date Requested AM PM BLD Location /t/-OM 67-1- � G[���� E he-1 Suite MEC Contact Person Ph PLM Contractor BCC .v,r) (D17'1 S7Y��Q» Ph SWR BUILDING Tenant/Owner erlt . /ij/'' ./Q 4 ELC Retaining Wall ELR Footing F Foundation NOT REQUESTED 1 FPS Ftg Drain FOUND DURING RESEARCH SGN Crawl Drain Slab NO INSPECTION(S) IN FILE SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing ' Oc,/L r. QS' A/6 Firewall Fire Sprinkler /iw.7.= cAdo..) ex-- A,p. c , c; :a � �1 Fire Alarm Susp'd Ceiling / �ui2 i...c 4 —�T, /AI .S - cnj A.1 ` —Q ' s T Roof Misc: 2 / 4// 75 e27-« Final PASS PART FAIL �eP v � PLUMBING Post & Beam • Under Slab Top Out Water Service Sanitary Sewer _ / Rain Drains A JO lT /� - ,)/}1I/�2 E i,,' /7 Final PASS PART FAIL e.A3 rA_C =/ — 70 Z o 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date ` / — / 7 fg Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION t6a b `' ate ti_.4"'...-- MST 24 -Hour Inspection Line: 639 -4175 Business Line. 639 417 Date Requested - 2 I AM PM ` P \ ° _ OW ?s Location /2e9/O S !A. W -4-- C4 74 4 f•1., •k C Suite MEC Contact Person • -,,, ' Li Ph 08 6d6 PLM Q Contractor �0 5 e R ocrt - L,r., Ph SWR / r BtlIEDTSIG> Tenant/Owner : -: , 4 6 r, .E_-/ , :. :.4 (,. _ ELC Retaining Wall ELR Footing ti.._ ...,2,..-:',.,2.i' • s ,; - T .. ,�,�_ •. .I, - t Foundation .4• c ti:►`rni. ; ' ` �c' !,.` >� + . 'r= ' 1�;,.= } » ∎•;.•j "r :- 'Y:- _ FPS Ftg Drain ;z 1 ;t7,.9„ ,Y- a..x;,1 =r_ � ;^ -;i . a' � '.'':�.1`si' Lri .' ,T-'_•: :;).f�' �4 . Crawl Drain Inspection Notes: / -^�, ( (� SGN Slab t. — a0 S U .1 (1GG,-,vC SIT Post & Beam Ext Sheath /Shear ,(7 /- ' " _ , ` • - L ��t�`E _ Q,9f Int Sheath/Shear t Framing .6-- .6-- C' 6.- -7 1 t.:4 ,, - -. 4/i -?% od k Insulation ._._ . Drywall Nailing Fire wall / 2 d7T � o Co 7 ( £ , / - -- Fire Sprinkler !� t -U Fire Alarm ,In " - Si —A-- Ceiling ��U I�1r c.�(T� ��Sr7 .�... _ -;���,,^ -� �'�l _ c�- . ��$.�- Roof Misc: —x `- "' ---( 6 'I, ill�� - S`Gt v`l 1=i AS PART FAIL N 1 `"''� 4 _5. "' � ° Post & Beam _mom p Under Slab a / A , ` _C_ - -. ». Top Out Water Service t.1 ■ 4 Sanitary Sewer . Rain Drains - / /1 Final / I - " /' � / PASS PART F • L —, /1 t ./l_,e . S' - 4, MECHANICAL I L ( Post & Beam / // ( Rough In 1 ) ` 3 Z) 7 . 1 1. . -�-�'- Gas Line Smoke Dampers ■ z Final ' 1 5 t PASS PART • IL �-"'�'�� I ELECTRICAL 3 Service N—/ Rough In UG /Slab • Low Voltage ) J �- . t--�n „ - I cz o v.,.__A Fire Alarm (1 ' ' J� V Final PASS PART FAIL SITE U C 7 ,, — . 0_ , 2-0,4 S l..t�,J \ c SankflWGree Sa Sewer -� r _p 1 ti �� c _ XJ4 %• . a Storm Drain [ ] Reinspection fee of $ required before next iipection. Pay at C Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: - [ ] Unable to i. spect - no access Fire Supply Line ADA Approach/Sidewalk / Other Date -2 /z//0 f Inspector / 1 t � Final PASS PART FAIL DO NOT REMOVE this inspectio}irecord from the job site.