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13219 SW ESSEX DRIVE
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
0 BTL' t?ODR F{1ANACE'
iQiQP cr OR LESS; a 'Vo alp.., i P X0(1! asp, .
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CITY CF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall elvd., Tlgara,OR 97223 (503)639-4171
he Unified "F•Idgf %ercy. T:e ff,t:1
date issued. TtF G1, munt paid +►il'
NBtait eMpareS. '�e does not guara-.`ef
sewf+' lal vat' r ' LF Sewer 15 notlc-eted i't "F xd" —
ns thf r,tai;e H'-05ptet ? feet in all directions ` ^l
lista^cF gi.F " ,c, located, the installer shall p'J"chase
"Tap and Side SFwe " " vit W the Agency will install a lateral.
1"EV'10N: ",•eiV lrl- ey ilres you to follow rjles adopted byC
I
Oregor Utility NcJ J i-:G',cr Center. Th..ose rules arF set fo-t1" :- pa^
�SF-Q►81-�IQ� tFr.,:y "rti! ?SC ,Bi--mat" You eat AWTi eopipi
`�fse ^ulfs d;r" -'`Jens to GINE by cailirg "A3124r._!7n".
Pian Chack V
'Y OF TIGARD Residential Building Permit Application Recd By r
25 SW HALL BLVD. New Construction Additions or Alterations Date Redd
Date to P E.
-ARD, OR 97223 Single Family Detached or Attached (Duplex)
3Dan to DST,,
-639-4171
3-6847297 Pem,rt to 7
!�l sT r/
Print or Type Calms--
Incomplete or illegible applications will not be accepted
—' Name of Pro{ea Name
�,tl.I- '�Il� f t. � i.� '
Job �
Architect Meiling Address
Address Site Address A t�
_ ;� �� �'�� City/State Zlp Phone
Name
Jit L It'Alt S 7N(z
Owner Mailing Address r Name L_'< tk
ll
I
I /)(- X ��� J� Engineer 411ifing Address
cityrsta4e Ph 9
itylstate Z►p Pttq e �i
Name
General `��!t t Describe work New f> Addition O Alteration'O Repair O
.:ontraetor Mailing Address Adddi done:
Additional Description of Work:
rty slate ZIP hgM
Gregon Const. Cont. Board Lia.# Exp.D
Attach Copy of
Current COT Business Tax or Met"# Exp. a PROJECT
Ucenses , t 5 'C `r VALUATION
Name v _ NEW CONSTRUCTION ONLY:
+Aechanical �'A� it , Sq. FL ouse: Sq. FL ge
Sub- Marling Address C, '
:ontractor J'' -/ 1 - I ..;w _ Comer Lot YES NO Flag Lot YES NQ
cityistate Zip Phone (check one) (check one)
f' Restricted AudiolStereo Burglar
OregonL;onst,Cont. Board Lic.# Exp. Date L
tach copy of �- I/tr `` Energy System — Alarm `
Current COT Business Tax or Me o r Exp. Date InstallaJon Garage Coor HVAC
Licenses ( 11 1 c -L /V _ ' Opener t Systems)
— Name (check all that Other.
Plumbing il t ! i I Lit, r;,, apply)
Sub- Mawng Address Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Contractor K Has the Subdivision Plat recorded? N/A YES I NO
citylstate Zip A �� v
Oregon Conn Cont.Board L,c# Exp.Date Reissue of MST#: Solar Compliance
attach copy of c` C C (Calr:ulabon Attached)
Current Plumbing Lia.is Exp.Dat° I hearty acknowledge that I have read this application,that the
Licenses information given is correct, that I am the awn!r or authorized
COT Business Tax or Metro# Exp.Date agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Name Signature of ter/AFeat : Date
Electrical 1 l t f L. f>t - cl _)
Mailing ailing A.,dress r_ _d6i;ae
P .on Na tie Phone 0
c
Contractor r litFOR OFF13E USE ONLY: f- f vc
city/state Z,0 ,.� y� -���' i ' Pat# Ma Tl#:
Orego "'oast Cont.Board L.c# E=o. Date If iC! c r` ;z
attach Copy of l+ Setbacks: ^j.`; t'-FcZ ne o- $olsr.
Current E!ectricat Lc.# Ext).Date 5'S" _ �( ep.
Licenses - f Engineering Apprcval: Planning Approval I TIF:
CO Business Tax or Metro# Exp.date
I SFAi D DOC (DST) 4J97
Permit 0 Acct. Descritpion COT WACO Amount
Amt. Pd. ®at, Duo
/Ho-f-1-0 q'i y MST. Permit (BUILD) (L)BUILD) I3t•.
73 8,
Plumb. Permit (PLUMB) (UPLUMB)
Mech. Permit (MECH) (UMECH)
154C/ELR Permit (ELPRMT) (UELPMT) --300,
State Tai? (i"AX) (UTAX) G " y o i--- o
BLDG:
PLUMB: / I
MECH: 2 , t
ELC/ELR: �,,�.
Plan Check
MST.. (BUPPLN) (UBUPLN) 4/79. '`� 1 Z
Z s�
(PLUMB) (UPLUMB) --�=--
Mech:
(MECPLN) (UMEPLN) // ///1 2
CDC Review(BUILD) (CDCBLD) (UpTC)
CDC Review PLN
I/ Sewer Connon (SWUSA) (USWUS �?0 U 07
Reimbur. District ( ) ( )
r
Sewer Inspection (SWINSP) (USWINS 3j— 3 '
Parks Dev Charge (PKSDC) �/A �6"557
Residential T1F (TIF-.R) (UTI -R) /V/ u `'
Mass Transit TIF (TIF-MT) (UTI -M) /3o "'
3t.,
water Quality (WQUAL) (UWQUAL) ::-� ,
Water duantity UWG!AN UANT)W ( T) � y e
( Q � U�
Erosion Control Prmt (ERPRMT) (UERPMT) _ S'
Erosion. Planck/USA (ERPLN) (UERPL.N)
Erosion Planck/COTG� r—
(EROSN) (UER0SN) �-��� C? G`
Fire Life Safety (FLS) (UFLS)
s �
TOTALS:
I SFAPP p0C (DST) 4/97
CITY OF TIGARID
OREGON
INTENT TO HAUL EXCAVATION
(print name), hereby certify that all excavation
material on the subject property will be removed from the site and not be placed as fill,
except for that amount necessary to back-fill the foundation ONLY. I understand that
failure to remove the excavation material will result in the requirement to remove the
material or obtain a grading permit by submitting grading plans prepared by a licensed
engineer accompanied by a geo-technical report regarding the placement of the
Excavation material as fill.
Je
5 )
Signat e p e
Job Address:
Subdivision:
—� -- Lot:
13125 3WO40*MD.M)nrd, OR 97223 (503)639-4171 TDD (503)684-2772
Box S. continued Sox B:
_. ,Measure change in elevation from front property line to finished Moor elevation. If
the lot slopes up From the front lot line to the foundation, the Figure is positive. If It
the lot Slopes down from tt.e front lot line to the foundation, the figure is negative.
3. Measure_ distance from finished floor elevation to the affected peak/eave. +
4. If the roof line nuns 'Vorth-South, deduct three feet, If the roof line runs East-West, � `l ft
dedua nothing.
S. Subtrar one foot for each foot of difference in elevation from the front property
line to the rear property line, if the Ict slopes up from the front to the rear. If the
lot has no slope or slope up from the rear to the front; dedua nothing. ( ft
6. Total Figure for box 8: It
Box C. Oistance to the. shade reduction line. Box C-
1.
1. Measure the distar_e from the North property line to the foundation near the ft
atTec ed peak/eav«
2. Measure the distance from the fovii-idation to the affected peak or eave. + � ft
3. Total figure for box C: (% ft
t
it is most useful to draw a verod tine to represent the appropmue%pR found in Haut-A-:.:d a horirontal 4w to rep vwnt the
aQpro}siaw rigune found in box'C.The inoerseckm of the vertical and horioo"lines determines the value found in box'O'. The value
in b= 'O'should be wmpared to the value in box'8'; if the value in box'9'is less titan or equal to the value found in Hoot 'O', then
-he buiiding is in mmo4uxe-with the solsr balance code. if you have Urf questions.pleue Contin us at 639-4171,x304 or at the
Community 0ev eioprnent Counter.
MAX]MUM PptMITTED SHADE POINT HEIGHT (In Feet)
Or=<e to North-south lot dimension 6n fe'b
srtAde 10U+ 95 90 85 80 75 70 65 60 55 50 45 40
mduc=ion line
f men northem
Inc inn Rn few _ L
70 40 40 40 41 42 43 44
65 38 38 M 3 40 41 42 43
60 36 36 36 3 38 39 40 41 42
33 34 34 34 3 36 37 38 39 u0 41
:0 32 32 32 31� 34 35 36 37 23 39 40
�a 30 30 30 ;1 32 33 34 35 i6 3.7 38 39
t0 33 23 23 2� 30 31 32 33 34 35 36 37 38
-�
25 26 26 2 23 29 A 31 3' 33 34 35 36
0 24 24 24 25 2.7 23 =9 110 31 32 33 34
.5 2-1 22) 22 ' 24 25 :5 27 23 29 A 31 32
:3 =0 20 20 2-1 23 24 25 25 27 23 29 30
13 18 18 18 9 20 21 2-1 23 24 25 26 27 28
10 16 13 19 20 21 22 23 2'4 _5 25
L-2-
14 14 14 15 16 17 18 19 20 21 2-1 2.3 24
Box D. Maximum allowed shade point height_ 17 feet
h�`hao` UoLar.ctio
zee sed
Solar Balance Point Standard Worksheet
Address
Box A calculations: North-South dimension for the IoL Box A.
This dimension is determined by finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine whiO property I'ne is the worth lot line. The North lot line is the line
with the smallest angle from a line drawn east-wesi and intersecting the northern most
point of the lot
e-5°
t
t
w N r. North-South
Dimension lot WL.
measure rhe distance from the midpoint of the North lot line to the South lot line along
zhe desc*,.ed line.
� feel
t
N
��an.ouw a�ria�
Box B calculations: Shade point height for your residence- Box B:
1. Determine whe.#_�er measurements will be based on the peak cr eave of your Which describes
structure- The orientation of the ridge is also important. your residence?
1 a: If the roof line runs North-South, measurements will (circle one)
be used on the peak of the roof. c o a c
1 h: If the roof line runs cast-West and the roof pitch is
less tan 31'l 2, measurements %viil ae ':ase^ cn !k.e
eav e. L=
*-4X-0"w
1r If ti-c roof lire runs Ea,—,- ,Vest and the roof aitch is I
S 12 cr steeper, measurernenrs will be based on the �._�...
r ea k.
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CITY OF TIGARD
DEVELOPMENT SERVICES
131 5 SW Hall Blvd., Tigard,OR 97223(503)639-4171
Pt--Rlvll*f #. . . . . ivi5"r97-0409
r)Ari:--' IT3":'3UED,- 01 /1.3/99
J-'S104r'A--01200
`3l TE ADDRSS. . . 13219 SW ESSEX OR
ST.)3 1.)1 V I S I ON. H I L.L SVI I RE ZONINGiR- 7
. . . . . . . . . . s LOT. . . . . . . . . . . . . v 0 1 2 JUP V-A)I C T I ON:T I G
CLASS Of- WORK. %NEW
f YFJIOf USE. SV
]- Pt;-' OF CONSTRr;jN
OCCUPANCY ORP. tR3
OCCUPANCY LOAD:2
Remarlis : NTH 1: NEW SIK%E FAMILI MILIM6 W/Aff"D GARAGE.
Owner ,,,
RJ DELORIT" ('0N ')INU['.TION It,)(-
# :
Contractors
IIJ DELORTe CONSTRUCTION
P 0 BOX 230434
TIOARD OR 97ckS1
Phony 638-3804
Req #. 000909
Thi S Cert i f itzatp grants occupancy of the shove ref ey-enced bui Iding or port i oyi
thereof and confirms that the building has Keen inspeotpd For Qompliance with
the State of Oregon Spec-iimlty Codes fuir the ray-()1jp4 occup�11cyq and usr under
which the referoncmd, 'permit --l-ostted.
BUILDING INSPECTOR
511pERVT''nr.
F-,(-)'-T IN CUNSPICUOUS PLA(--'E
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 97 e 4161
24-Hour Inspection Line: 639-4175 Business Line: 639-417
BLIP
� ' Date Requested 41L� __PM BLU
Location z / Suite MEC ----------- ----
Contact Person Ph .���S����GY1 PLM
Contractor Ph g�r,fQ - 7Sj-0 rnAbkSWR -.....
BUILDING Tenant/Owner C L /. ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain SGN
Crawl Drain Inspection Notes:
Slab �-C�C_ SIT
Post R Beam
Ext Sheath/Shear
Int Sheath/Shear - -
Framing it -4-22 Ad, '272eyGr't/,9i_4t `d?�sG l,�wti�:e14 C.
Insulation Nailing
/ZZ>
Drywall ailir. A e g Pro-.-i
Firewall
Fire Sprinkler L Z-114 .u.e JK 5:104Cd, 17�.a y e
Fire Alarm a�
Susp'd Ceiling
RoofMisc: � rZdc rnlc/f4.
4ASSA RT FAIL ATrO-/ /NS U� ivL4 P -') Z- Z O- 9 R, - --
BING _
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains /�` - `�- Alwy : - I S !'Avl
Final
ASS_ RT FAIL 4%Tf �
- I�LG_LL,'f'</ice -� ---
MECHANIC
L'
Post& Beam - �!
Rough In - --
Gas Line --- - -
Smoke Dampers
AS PART FAIL
E r
L
LIECTRICAL
Service
- - ---
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL_
SITE
Backfill/Grading - - -
Sanitary Sewer
(Storm Drain [ J Reinspection fee of$_ ,required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ J Please call for reinspection RE: _ [ J Unable to Inspect-no access
Fire Supply Line
ADA C
Approach/Sidewalk Date ���� - �7 Insr ?ctor Ext
Other - ——
Fine
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.