Case File ADDRESS:
i.\records\microflm\targets\building.coc
1
CITY OF TIGARD BUILDING INSPECTION' NOTICE r�
Inspection Line (Rec-O-Phone): 6 9-4175 Business Phone: 639-4471
Inspection.-
Footing
nspection:Footing Susp. 'oiling Sprink. Rough-in Appr/Sdwlk
FOundallnn Plbv. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Flbg. Top Out Elec. Rough in FINAL:
Post/BeLm Mech. `;an. Sewer , Gas Line ( _g
dq
Plbg. Underfloor Rain Drain ✓ ji1 Framing -Plumb,
Alarm Water Line Insulatic:i -Mech.
Underfir, Insul. Shear WallGyp. Bd. -Elect.
J
Date Requested: i ( ) `� Time: AM _ PM
Address:
Builder:+ Permit #:
THE FOLLOWING CORRECTIONS ARE REOUIRED:
��-
Insp r: 'Af bate:
PPROVED __DISAPPROVED _APPROVED SUBJECT TO ABOVE
-_Ua'l For Reinsp
l.L�
l
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (RF -O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing-' Susp. Ceil:-Ig Sprink. Rough-in ppr/Sdwlk
ung. Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer G-s Line -Bldg.
Plbg. Underfloor Rain Drain Fram ng -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested: �� ( Z- �c'�l S Time:�AM PM
Address:� J- a �CLl1- t C
Builder: c/ - �c 5 O 3 Permit tt:
THE FOLLOWING CORRiECTIONS ARE REQUIRED:
I
Inspector:_ _ Date:
APPROVED DISAPPROVED �APPHOVED SUBJECT TO ABOVE
Call For Reinsp.
CITY' OF TIGAR�3mf��7, R 7COMMUNITY DEVELOPMENT DEPARTMEN'srEPMTT �.. . . . . . : w3-"%T
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)09-4171 DATE :SSUED: 06/OP/95
PARCEL.: 10134CA147MO
'ITE ADDRESS. . . a 1. 16'-'S SW * DR
.;UBDIVISION. . . . : PURLWOOD NO. 2ZONING: R-A. 5
t J3T. . . . . . . . . . . . . ..2 0
SUILPING
r 1,5,S)I i r. DWELLING 1JWTJ.0 DA"PEME1114*11 . . . . . . . . :1Z f
(46S OF WORK. ir;Dl) BEORMStO SATHS&0 GARACIr. . . . . . . . . . .300
,-',E or USE. . . :CF' 7LOOR AREA"i - REQUIRE-70 S[:- TPACVr' - --
: YPE Or CONST. :5N FIRST. . . . :0 +:,f LEFT—@ ft RIGIAT. :7 f
'.Cr.UPn. NCY CrP. ; P'71 SE COND. 0 Sf !-RONIT. :0 ft REAR. r17r f
3TORTES. . . . — : 1 FINDGMENT:0 sf REQUIRED-
}EIGHT. . . . . . . . u110 ft TOTP,'-- -- - :0 .3f SMO!'E DETECTORS. :
LOOR LOAD. . . . t40 psf VALUE. . . . . t 1 4881 PARKING CPACES'. . :0
emarks : ADDTNG A 51-10P AND GARDEN SH.F-D 30+0 so f
PLUMBINGs
"INKS. . . . . . . . . . r 01 r1_0011 1: R11iN[% -0 OArt'ri-r1W PRF1 'ITRS. .0
PVATDRIES. . . . . :0 WATER HEATERS. . . :0 TRAPS.
1*1.jp!S)H0W_R`,- 1Z LAUNnPY TRAYS„ .. -.0 CA T!':I I r.A'T 0
, 'ATER CLOSETS— ;0 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . so
;0 WATEP 'LINt. (ft ) . .0 1THIL-r. rj),Tupr�. . . . o
A11RRAr7C r)ISP. .0 PAIN DRAIN (ft ) . jO
-I- RAIN DPATNS. ;0
r1f1CH. -0
MECHANICAL rEES
1 ypr, j_ UNIT HTr,-. , - o )Ili)p amr,mt by date
VENTS . . . . .0 SPRT 50. 50 inn 06/08/95
I -jW
INPUT:.' LTU 'TNT FONr). . .0 "j-1 (7. 1 r B3 121c,/07.
u. rIN ( A0K . . .0 HOODS. . . . . . 30 svr*r 2. 53 JDr ke*/08/95
'URN . . .0 14010r.,ST111JES. s0
LOOR FUr: 1. . . :0 CLO DRYERS. : 0
;:,OIL/CMP ti 3PP:0 OTHER UN TO. :,I
0,A0 OLJ,rL[-.TS:0
wner
11CHAEL HOLMAN
1617'5 SW SURL(' REST
IGARD OR 9722a
11011p 4#8 :7,10-302p
ontractov, :
'111ne Vit:
t 05. 66 TOTAL
;is persit is issued subject to the regu4tions contained in the RrQUIAED INSPECTTON.:-I
yard Municipal Code, State of 'i-e. SPICIalt) Codes and all other F*c)otinq 'Itisp
r-plicAbl@ laws, Al) wvk will be done !n arcordahcF with approved Fr-Ami nq Insp
Isms. This Permit will expire if wdrM is -st started within 160 Rain dvairi lyisp
Or If avork Is ^ days. J3(AiTcJ1nr4 1"Ir1Al
Al c t i o n C.,21)- A 175
t
CIT,f nF TIGARD — RF'CEIPT Or PAYMFNT RECEIP7 NO. a 1)ti-.2 6 65 0 7
CH�'C,K AMOUNT t-)3. 0 1311
lvltCf4Pt.L HOLMAN AMOUNT t 0.00
ADDRFSS t 11625 SW SURLCREST DR. PAYMENT DATF s 06/08/9'.
GUSD I V 15 1(IN
TIGARD, OR 9722-3—
PURPOSE OP POYMENT AM(7LIN T 1''AI1) PURMF3F OF* PAYMENT AMOUNT VIA11)
SU"L.DING PERM MST95-0233 L50. 710 si. BUILD PFR 53
I ICc:'5 ►',W SHRL(.-,RSl'
"' IL AMOUNT P(-*01) 1 5-3. 03
6
Residential Building Permit AR12lication
City of Tigard ,� r
13125 SW Mall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobelte Address:
Subdivision: - r kou0c] Z- Lot �p OfRea Uee Only
Valuation: — tl.��� �1f � , - PlanclJRec #_62 - / 2 rc-
Corner Lot? Y Permit# J7 '>� _ :�G.
Flag Lot? K !N� Reissue of
Map&TL#1 jr t 3 2 (-f) 1000
Owner: ��. ��J F y�>14�
owneC7►'lE. F'- ` 5
— A.perovals Required
Address: /C.2 s
�— P!anning � -��.� �—
--- Engineering
Phone: 2 _ Other
Contractor: Items Re ui,ea
Address: _ — Suhrontractors
Truss Details
Phone: ._ Other
Contractor's License # _
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors: Archltect/Engineer._
Plumbing: _ ify^/te7 Address:
Mechanical: /"- u /J F
(attach copy of current OR Contractors Ucense)
Phone:
JOB DESCRIPTION:
7 Z
Applicant Signature & Phorfe number _
Received by: _ ,(���-� . — 0ift Received:
Permit 9 Account Dascription Amount Amt. Pd. ilial. Due .
!; t4
_ILL:7 Brig. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) _ -S.3
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) 3 32. �-
Bldg: ' ✓
Plumb:
Mach.
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) ____ •
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TF-C)
Industrial TIF (TIF-.')
Institutional TPF (TiF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) _
Water Quantity (WQLIANT)
Fire Life Safety (FLS)
Eresion Cnirl Permit (ERPRMT) _-
Erosion Planck/IJSA (ERPLAN) _
Erosion Planck/COT (i_ROSN)
TOTALS:
WAA
CITY 01' TIGARD
BUILDING DII, ISION
RESIDENTIAL PLAINS SUBMITTAL
APPLICANT NAME: y_ PLAN CHECK #
ADDRESS: PHONE #
DATE RECEIVED: _ _ RECEIVED BY:
CHECKLIST (All items must be in packet before plan will be reviewed)
YES NO N/A
1. r] [ ] [ ] /3 FULL SETS OF BUILDING PLANS (No red line revisions
or tape-ons).
2. [ ] [ ] [ ] 5 SITE PLANS(including tax lot anti tax map number,easements,
erosion contrul provisions, floor elevation of garage and main
floor, set backs, drive-way location, north arrow, scale, location
and termination of rain drains,all property cornerelPvations,and
contours if over 15% grade).
3. [ ] [ ] [ j BUILDING PLANS SHALL REFLECT TOPOGRAPHY OF LOT
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
}. [ j [ ] [ ] REVISION TO PIANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (detailed sections may be
different from the originals as a result of your changes. These
portions of the structure that Pre affected by the change need to
be reflected on the plans. No real lines will be accepted).
5. [ ] [ ] [ ] FLOOR PLANS)
e [ J [ ] [ J FLOOR FRAMING
7. [ ] [ [ J TRUSS JOISTS (engineering, details and layouts)
8, [ J [ ] [ J ROOF FRAMING PLAN (all hips and valley supports indicated
and derailed).
- OVER —
Jar
YES NO N/A
9. [ ) ( ] [ ] ROOF TRUSSES (engineering, details and layouts)
r' 10. C 1 [ 1 [ J COMPLETE CROSS SE( TION(.;)
11. [ ] [ ] ( ] ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] [ J ( ] BASEMENT WALL, FOUNDATION AN n- RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
1.... ( J ( J [ ] WALL BRACING (structure must meet table R-402.10, revised
alternate method 93-7, or a lateral design ;h 311 be provided)
14. [ ] [ ] [ ] ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. No att hMgnts are
allowed.
15. [ ] [ ] [ ] BEAM CALCULATIONS (all beams over 10 ft. in length or arty
beam that supports a point load).
16, [ ) ( ) [ ] ENERGY CODE PAT:1 IDENTIFIED
DO NOT MAKE CORRECTIONS IN RED
NOTE: A tree removal permit shall be required for cutting of all trees that are 6" or
larger in diameter at 4 feet above grade. Permit application forms are
available from the Planning Division. Two copies of a site plan showing the
location of the trees and proposed building are required with the application.
jt/submit.ls
Permit#: MST X15' Q 23 3
Address: /I Cr 2S 6W
Issued by: ;9,LA 't Date:
Statement: Information (Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit
cants who are riot registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registraticn under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2,and either box 3A or 3B:
a1. 1 own, reside in,or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
" 3A. My general contractor is---�
(Name) Contractor regis. #
I will instruct my general contractor that all subcot ractors who work on the structure must be
registered with the Construction Contractors Board.
OR
F/-k] 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with. a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
1 hereby certify that the above information is correct and that i have read and do understand the Information
Notice to Property Owners about
Construction Responsibilities on the reverse,.ide of this form.
(Signature of pefmit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
5'
N
i0•W
s
y•b �4 �
� s
V. LC?, r DP,
LD-Y 10 BL-0 q , b UkL\.,\/Coo neo. 2.
Cl T`( OF T I b A R U W ASAI W hTc`P Cote uTY o4Z
f
POT " _ 10
PLAN
i
c I TY CIF 'T I GARD — RECE I VIT OF PAYMENT kF.CE I PT NO. -45-266E9:3
CHECK AMOUNT s alt. LAO
NAME a HIOLL MAH MIGIIAk:L_ R. CASH AMOUNT 1+0. Q0
t11:)bRESl3 d 116c.55 5W T�URL.f..REraT F',PYMENT DATE: 41E.i�5/9`
TiQARD, OR SUBDTVI STON x
9'72'23 -
PURPOSE. OF PAYMFN T AMOUNT PAID PURPOSE OF PAYMENT AMCILINT PFS I D
PI.gN C:HE.C;K FE� 6•-i c"'fd ..._......... 32. 63 ....___•_._...._.._._.._.._............._._.__.�. __...._......._....._..._,.._
c3Al�lF
fr1 CA1... AMOUNT PAIL)