Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP1999 -00417 •
1 • DEVELOPMENT SERVICES DATE ISSUED: 10/04/1999
c �' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1106D -00700
SITE ADDRESS: 11870 SW WILDWOOD ST
SUBDIVISION: SHADOW HILLS ZONING: R -2
BLOCK: LOT: 005 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W: •
OCCUPANCY GRP: R3 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED •
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,000.00
Remarks: New'openings for two new windows
Owner: Contractor:
COUCH, DICK & BETTY NEIL KELLY CO
11870 SW WILDWOOD 804 N ALBERTA ST
TIGARD, OR 97224 PORTLAND, OR 97217
Phone: Phone: 288 -7461
Reg #: LAC 001663 •
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PLCK BON 09/27/199E. $38.51 99- 318457 Final Inspection
PRMT DST 10/04/199E $59.25 99- 318814 ORIGINAL
5PCT DST 10/04/199E. $4.15 99- 318814
Total $101.91
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty 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.
Pe rm itee
Signature: /� ,
Issued By: ce/ s �'
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
� Plan Che #
3ITY OF TIGARD Resi dential Building Permit Application
• 13125 SW FALL BLVD. Alteration - Interior Only Recd By y
Date Recd 0 2
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. ° l• 23-1
V 503 -639 -4171 Date to DST 9 -2g-4Q
F 503 -684 -7297 Permit # I Ali - �7
Print or Type Called IO - 1 - 1'7
Incomplete or illegible applications will not be accepted
Name of Project Name
Job LOu c_vA c,.1Y4.k CEA.) GZi94.11c1 -, at _icvx ko t„' - ti C\
Address Site Address
Architect Mailing Address
I 1 7 c 3,„:1 . ll,.sl (:\ () E k1. �t.dt -.0. A
Name City/State Zip Phone
a \_c_te, t r E)c�!',K N 1 L.�d.l�� c"ii2.97 )( 3:\5 ? lam
Owner Mailing Address
i I Al 0 fl ``�\' t `� A En sneer Mailing Address
ity /State Zip hone g. �' -c��o i M.9 2 > I ? O `�fn(o`( City/State Zip Phone
General - Name
Contractor lam[ r IL., 1ej,.. y Ltd Describe work New 0 Addition 0 Alteration Repair 0
Mailing Address t to be done:
Prior to permit 6 oil I rt LaabrWCI _ Additional Description of Work: �c..c` ' .r l"I.P.(. ,
issuance, a copy City/State Zip Phone t-0\ Z (\( t tn. t. \ P.1Nflc3�.
of all licenses 2t.,VV .lNnn 0q2 9 7741 .21
�
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lice VALUATION $ 3 l ` Q-49-. database
Mechanical— - Name - -- — — - - -- NEW - CONSTRUCTION ONLY:
Sub- Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address
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 YES NO
Prior to permit City/State Zip Phone
issuance, a copy _ Solar Compliance
of all licenses are Oregon Const. Cont. Board , Exp. Date (Calculation Attached)
required if Lic.#
expired in COT 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
of the owner, and that plans submitted are in compliance with
Oregon State law .
Name Signature of 0 er /A Date
Electrical - 4✓ e ?12 o ft P
Sub- Mailing Address Contact Person Name Phone #
Contractor X 10-4 a- t« -tP.l ► � 3•3s 9210
FOR OFFICE USE ONLY:
City/State Zip Phone Plat #: Map/TL #:
Prior to permit
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date Setbacks: Zone: Solar:
required if Lic.#
expired in COT Engineering Approval: Planning Approval: TIF:
database Electrical Lic. # Exp. Date
Electrical Supervisor Lic. # Exp. Date 6 \
V %1
i:forms■sfintalt.doc (DST) 10/23/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line:, 639 -4175 Business Line: 639 -4171
/ BUP /409-00(07 Date Requested 11 ("119 / AM / � PM BLD
Location /( riO �, � a'8� Suite _ MEC
/ ,, ,
Contact Person � ►' 1 //- C Ph gag a'� 1 S PLM
Contractor Ph SWR
ILDING Tenant/Owner ELC
Retaining Wall ELF
,4
- Access: FPS
Ftg Drain SGN
Crawl Drain • Inspection Notes` 6 j S u b
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear •
Framing '
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
i
P PART FAIL -
- COMBING
Post & Beam
Under Slab �.� � ►- � 1
Top Out � 47 � - • p V
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 \ C
UG /Slab �J
Low Voltage -
Fire Alarm
. Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 O
Date ae ` Ins Ext
Final • PASS PART FAIL DO NOT REMOVE this ins tion reco from the job site.