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OF TIGARD MASTER PERMIT
PERMIT #. . . . . . . . MST97—0`14`4
DEVELOPMENT SERVICES DATE ISSUED: 01/08/98
13125 5W Hall B!vd., Tigard, OR 97223 (503)639.4171
F'ARCE,.: 1 S 135DC-0_,001
SITE ADDRESS. . . : 11551 SW GREENBURG RD
SUBDIVISION. . . . :FIRDALE ZONING: :
TT
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . JURISDICTION:
Remarks: Moving doorway two feet.
Bi1iLD1NG ---------- ------ -- ------------------ -
RcISSUE: STORIES......... 0 FLOOR AREAS-- - ---- BASEMENT...: P sf REQUIRED SETBACKS---- REQUIRED------------
CLASS OF WORK.:ALT HEIGHT........: 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMCKE DETECTRS:
TYPE OF USE...:SFA FLOOR LOAD....: 0 SECOND...: 0 sf FRONT........ • a PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT......... : 0
OCCUPANCY GRP.:Rol BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE..S: 1200 REAR........... 0
------------------------------------------ --
----------------...- PLUMBING --------------------------------------------------------------_
SINKS......... : 0 WATER CLOSETS. : P WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
I-AVATORIES...... 0 DISHWASHERS... 0 FLOOR DRAINS..: P SEWER LINE ft: A SF RAIN DRAINS: A CATCH BASINS..: 0
TUB/SHOWERS...: P GARBAGE DISP..; d ATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: P GREOTHFASE
FIXTURES:RES: P
MECHANICAL ---------- --- -------- - - ---- ------ ...
FUEL TYPES-------- FURN ( IBM ..: 0 BOIL/CMP ( 3HPs 0 VENT FANG.....1 0 CLOTHES DRYERS: 0
FURN )=1001, ..: 0 UNIT HEATERS..: 0 HUODS.........: 1 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.......... 0 WOODSTOVES....: 8 GAS OUTLETS...: 1
---------- ELECTRICAL ------ --- --------------------- ----------
-RESIDENTIAL UNIT--- --•-SERVICE)FEEDER-- --TE"? SRVC/FEE.DERS-- ---BRANCH CIRCUITS--- - --MISCELLANEOUS _ -nDD'l INSPECTIONS--
1000 SF OR LESS: 9 0 - M .up..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5005F.: B 201 - 400 amp..: 0 201 - 400 alp..: 0 1st W!O SVC/FDR: 0 SIGN/OUIT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: P 401 000 alp..: A EA ADDL OR CIR: 0 SIGNAL/PPNEL...: 0 IN PLANT......: 0
MANF HM15VC/FDR: 0 601 - 1000 amp.: 0 601+amns-1000 v: h MINOR LABEL. -10: 0
1000+ amp/volt.: 0 -----------------------
------------- PLAN REVIEW SECTION -- - -- ---- _-_--.-----____-_
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: LLS AREA/SPC OCC:
---------------
-------------------- --- - --- - ELECTRICAL - RESTRICTED ENERGY ------------------"'------- - - - ----
A. SF RESIDENTIAL-__----------------—- - B. COMMERCIAL----------------------•-------------------���_— --...------ --------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: BOILER........... HVAC...........: LANDSCAPE!IRRIG: PROTECTIVE SiGNL:
GARAGF OPENER.. CLOCK... INSTRUMENTATION: nEDICAL......... OTHR: :.
HVAC.......... .
DATA/TELE COMM... NURSE i;.ALLS....: TOTAL N SYSTEMS: 0
Owner: ------------------ -- --__
------ -Contractor: ------------------------------ TOTAL FEESO 68.75
11ICKIE HUANG O1KR This permit is subject to the regulations contained in the
11551 SW GREENBUIRG RD Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This perm.t will expire if work is
Phone R: 273-4137 Phone N: not started within 180 days of issuance, or if the work is
Req C.: 000000suspended for more than 180 days. ATTENTION: Oregon law
----------—------_---------------_-----------------------.----------
requires you to follow rules adopted by the Oregon Utility
Notification Center. Thnse rules are set forth in Mgr 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1981.
----- REQUIRED INSPECTIONS -----------------------------------------------------------
Mechanical Insp Rain Drain Insp ---
Framing Insp Mechanical Final — ------
Gas Line Insp Building Final
Insulation Insp
Gyp Board Insp � — --
Issued By -
Permittee Signature
++++++++ + +++++++++++++ +++++++ a+++++�+•++++++++++++++ ++++++ +++++ ++ +
Call 639-4175 by 7:0 p. m. for an inspection needed the next b�_i5iness y
Plan Check Z'
CITY OF TIGARD Residential Building Permit Application Recd By
13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'u
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P E I I-
V
X17_
V 503-639-4171 Date to DST-1--
F
ST -F 503-684-7297 Permit# 177 TT ht
Print or Type Called 1
Incomplete or illegible applications will not be accepter!
Name of Project Name
Job J.N. kLto_i, --
Address Site Address — Architect Marling Address
Name II City/State Zip Phone
Name
Owner Mailing Address
- � Phone Engineer Marling Address
—k- e
City/State g
- Zip Z Z 3 3- Citytate Zip Phone
Geneval Name ( -'
Contractor r_� t- Describe work New O Addition O Alteration}# Repair JZ
Mailing Address to bedone VICIf LDooR kJAV .2-. +o 94L,'" /,vs-jt A165.41
Prior to permit Additional Description of Work: 4ZZI ' >VuV—r wAy.
issuance,a copy City/State Zip Phone —Wi N 046re
of all licenses _ (Zy (/u{ w- AS
are required if Oregon Const Cant Board Exp Date PROJECT • J
expired in COT L.ic.# VALUATION $
database _
Mechanical Name NEW CONSTRUCTION ONLY: _
Sub- _ Sq. Ft House: v [Sq. t. Garage
Contractor Mailing Address _
Prior to permit _ C Comer gat YES NO Flag LotT!P46
issuance.a copy City/State Zip Phone (Check one) (c'*,eck one
of an licenses _ Restricted Aud'n/Stereo Burglar
are required it Oregon Const. Cont. Snard Exp Date Energy Syst. .n _ _ Alarm
expired in COT t.ic# _ —
database Ir.stallahm� Garage Door_ VA
HC
Plumbing Name __�____ _ Opener Systems
Sub- (thee(all that Other
Contractor Mailing Address appy)
Will the electrical subcontractor wire for all YES N-1
restricted energy installations?
Prior to permit City/State —V Zip Phone Has the Subdivision Plat recorded? NIA YES NO
issuance, a copy
of all licenses are Orr,gon Const. Cont Board Exp.Date _ —�_.
required if Lrz# Reissue of MS-r#: Solar Compliance
expired in COT _ _ '�(Calculation Attached)_
datahase Pluw.�nn Lic.# Exp.Date I hearby acknowledge that I have read this application, that the
information given is correct,that I am the owner or authorized
Name agent of the owner, and that plans submitted are in cu,;.nliance
with Oregon State laws.
ElectricalSi
Owner/Agent -- —
gnature of OwneNAgent r/1 Data,/
Sub- Mailing Address !r /L j/.2,12 7
Contractor Contact Person Name P one#
City/State ~ Zip Phone Lie
Prior to permit FOR OFFICE USE ONLY:
ssuance, a copy _ _ Plat#: MeplTL#:
of all licenses are Ooegon Const Cont Board Exp Date _ AAJj p
required if Lic# Sefb1S: Z07: Solar:
expired in COT / j
— database Electrical Lic # Exp Date E girlee ring Approval: Plannir Aproval: TIF:r
( irk
'SFREM DOC (DST) 4/97
CITY OF TIGARD Site Permit Application
13125 SW HALL BLVD. _QIM_eLG.lsal: Complete ENTIRE form
TIGARD, OR 97223 BesidenQe: Complete SHADED areas
`503) 639-4171 x304
Print or Type
Incomplete or illegible applications will not be accepted
Projekt N me — Utilities(Complete all that apply)
Jab j:. ,► - IARPI-- - -----
Address Address Storm Sewer
� i4 vA Linear Ft.
Name V Sanitary Sewer
_ Linear Ft.
Owner Mailing Address --resh Water
Linear Ft.-
Cr
t.Ci State Zip one Catch Basins
General Name Clean Outs
Contractor
Pry to pemxt Mailing Address Describe work ;o be done
taauance,a Newo Additiono Alteration Repair
copy of all _ _ _
kanses are City/State Zip Phone Additional Description of Wolk'
eitmed in COTState Const. Cont, �aerd Lfc.# Exp.Hate _ 0 lle4I-°?,C ON WI4-it
databa ' ,1,. l (af1�tiG,-/ 1"
Name :
!
_ Project
Valuation �►
Architect Mailing Address-� Plans Required: See Matrix on back
The following,must accompan this application:
City/State Zip Phone Site plan with Vicinity Map Parking(including
_ Showinq ADA compliance ADA)&Ujhting Plan
Name Grading Plan and details Landscaping Plan
Engineer Mailing Address J� Erusion Control Plan and Retaining Structures
details including calculations
City/State Zip Phone Site Utility Plan and details Soils Report
showing connection to (if required)
_ I ap,xoved system`
Excavation Volume I hereby acknowledge that I have read this application,that the
(Soils report required for>5,000 cu. Yards information given is correct,that I am the owner or authorized
cu yds agent ai the owner,and that plans submitted are in compliance
---J-- - ------ —
with OTgon State laws.
Fill Volume Signaturq of Ch1herfAge Date
(Soils report required for >5,000 cu. Yds ) t �tCtdlt.` I /f"%
_ cu. yds. I
Will the fill support a structure Cont t Person e_r S Phone �-
(Engineer required if answer is yes) YES❑ NOp r )r 'r�` t. j 71,j
-q.1
Retaining structure?(check one) — C7Rock FOR OFFICE USE ONLY
LJ CMU Notes:
❑Co:lcrete
pOther_
i
Total new impervious area including all — Land Use Case# MaplTLtt
buildings, sidewalks, and paving — _ Sq. Ft
siteapp.doc9/97
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE `E,PE CPE PPE EPE
SITE 1 1 -- -- 3 O,o,u) -- --
B (New or Add) 1 1 -- -- 3 O,o,w) -- --
F (New or Add or.Alt.) 3 3 -- -- 3 O,o,f)
M (New or Add. or Alt) i i -- -- 20,o) -- --
B & M (New or Add) 1 1 -- -- 3 O,o,w) -- --
P (New, Add. or Alt) 2 -- 2 -- -- I 20,o) --
B & M & P (New or Add.) 2 1 1 -- 3 O,o,w) 20,o) --
E (New, Add, or Alt) 2 - -- 2 "" "- 20'o)
B & M & P & E (New, Add) ,
3 1 1 1 3 O,o,w) 20,o)
B or B & M (Alt) i 1 1 __ .. 2 (j,o) -
B & M & P(Alt) 3 1 2 -- 20,0) 20,o) --
B & M & P& E (Alt) 3 l� 1 L1 20,o) 20,o) 20,0)
NQT��
Kul
: .
a. Before returning to DST. Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o =Office M = MEC
updates and adds actions. f=Fire P = PLM
u =USA E = ELC
b. Shaded areas designate ALT submittals only. w= Wash. Count F = FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997,Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calcuiations.
h knatne Doc
Permit*
aF O
Address:
Issued by: _ Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not 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 registration under ORS 701.010(7),
need not submit Ili is statement. This statement will be filed with the permit.
Fill in the appropriate blank, and initial boxes 1 and 2, and either box 3A or 313:
ITI1 . 1 own, reside in, or will reside in the completed structure.
LEl2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
-t before or upon completion. i
(�
IA. My general contractor is
U (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must he
registered with the Construction Contractors Board.
OR
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.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Propertk Own s about :onstruction Responsibilities on the reverse side of this form.
(Si ature of pe it applicant) (Date) 1'
(White copy to issuing agency permit file,
pink copy to applicant)
Inform,ific-in Notice to Property C.,viners
(. f.r ., � r;,,. , .i, � „t,1 ,�� i, err. �;,; �,• •1' },1.
ilk „ !i IL •1 r r. e» r,i., n..,.
4 !nt' !.' �_!!',t'. �y•etr�i t :r.. .. I �', ;lig. � :�- i�. .,.. u1,�
plioa,. '�l ,k r ..!..•.,••.��t�. . ^ht• .. I•,.t1�e,•�.�Ji.1,,, ty!(�il,.'il C�'11f'1':I�;'f!Ilf'1C•�,"�r ( �;tl!+�`f�111af'•1}I,.`,.ri('�1,' .•,�It�,'. 111
l nfI•Ir I: I•, i41 n;faj lilt 11<n. 1 11..111 ♦ ,inn, it 1.)
,!
NI ` jflt.' IN), w1 Sake!
CITY CSF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : MST98-02'62
13125 SW Hall Blvd,, Tigard,OR 97223 (503)639-,1171 DATE ISSUED: 07/01/9B
PARCEL: 1S135DC-03001
SITE ADDRESS. . . : 11 51 SW GREENNURG RD
SUBDIVISION. . . . :FIRDALE ZONING: R-4. 5
BLOCK. . . . . . . . . L_OT. . . . . . . . . . . . . . JURISDICTION: TIG
Remarks: REDOING STAIR WAY '
--------------------------------------------------------- BUILDING
REISSUIE: STORIES.......: 1 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED ----_-_.._.-_
CLASS OF WORK.:AL.T 4EIGHT...... ..: 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD....:100 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0
TYPE OF CONST.:SN DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.;R3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE_$: 1000 REAR...,...,..: 0
-__ ----------------- ------ ------- ----------- - PLUMBING ------------- - ______—_— -----------------
SINHS.........: 0 WATER CLOSE.TS.: 8 WASHING MAC;.,: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 0 DISHWASHERS...: 8 FLOOR DRAINS.. : 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BANS..: P
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------------------------------------------------------------- MECHANICAL -----------------------------------•-------
FUEL TYPES---------- FURN f 180K ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS....... 0 CLOTHES DRYERS: 0
FURN >=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 8 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES...... 0 GAS OUTI.ETS...: 0
ELECTRICAi- ----------------------------------------------_—_---_---------
—RESIDENTIAL UNIT--- --9ERVICF/FEEDER---- --TEMP SRVC/FEEDERS-- ----BRANCH CIRCUITS--- ----M15CELLANEDl15---- --ADD'L 1NSPECTIONS-
1000 SF OR LESS: 0 0 - 288 amp..: 0 0 - 288 amp..: 0 W/SVC OR FDR,.: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 8
F_1 ADD'L 500SF.: 0 201 - 400 amp..: 0 281 - 488 amp..: 0 1st W/O SVC/FDR: 0 SiGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 60P amp..: 0 401 - 688 amp..: 8 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1008 amp.: 0 681+amps-1888 v: 0 MINOR LABEL -18: 0
1VhO amp/volt.: 8 ----------------------------------- PLAN REVIEW SECTION -----------------------------
Reconnect only. : 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 608 V NOMINAL: CLS AREA/SPC OCC:
-------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ------- --------------------------------------
A. SF RESIDENTIAL--- B. COMMERCIAL--------- --------------____—..------—--------w--------------------_.—w
AIJD!O 6 STEREO.: VACUNJI) SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PA(ANG: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIW
GARAGE OPENER..; CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC.....,..,..: DATA/TELE COMM.% NURSE CALLS....: TOTAL N SYSTEMS: 0
Owner: --- ------------------------------Contractor: --------------------------- TOff,L FEES:t 42.50
JACKIF HUANG LAMBERT, LEROY LARRY This permit is su'i)ect to the regulations cictained in the
11551 SW GREFNBURG RD 3031 SE 120TH AVE Tigard Municipal Code, State of Ore. Specia.ty Codes and all
TIGARD OR 97223 PORTLAND OR 97266-1057 other applicable laws. All work Mill be dono in accordance
with approved plans. This permit pill erpire if work is
Phone #: 273-4137 Phone C 503-761-0966 not started within 180 days of issuance, or ;.f the work is +
Peg C... lc?698 suspended for more than IRO days. ATTENTION: Oregon law
------- _______ requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in ON 952-881-0818 through OAR 952-801-0080. You may obtain copies of these rules or
direct questions to OUNr by calling (503)246-1987.
------------------------------ ------------_—M_M_ REQUIRED INSPECTIONS
Framing Insp
Building Final 4_
I=_si-ied By : Permittee Signati-ire :
++++i-+++++++++++++++• + ++++++++++++++ +i• ++++++++++++++ +.F + + +++++++++
Call 639-4175 by 7: 0 p. m. for- an inspection needed the p/ext bi.isiness day
Plan Check#
CITY OF TIGARD Residential Building Permit Application Recd By i� r
1312,5 SW;jALL BLVD. New Construction Additions or Alterations Date Recd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P E.
V 503-639-4171 Date to DST_ 2 f'
F 503-684-7297 Permit# YYl 3>` 9�'0.26 Z
Print or Type
Incomplete or illegible applications will not be accepted
i -- Name of/Project ��— Name --
Job I C` Address=
Address Site Address n Architect Mailing
—^ Name City/State7_ip Phone
l<' 11/Ltt:n 5 — — �—
Owner Mailing Address — Name
City/State zip Phone
Engineer Mailing Address
General
Name City%State Zip :E!!��n --
Contractor , U t, '2r{ f Describe work New O Addition O Alteration O Repair O
Mailing Addr s to be done'
Prior to permit Additional Description of Work:'K 7
✓
issuance,a copy City/Slate Zip Phone / Pr�V/-}� ,.S / (,�.Ja
of all licenses (•/-0 Ifo
are required if Oregon Cons!.Cont. Board Exp. Date PROJECT
expired in COT Lic# VALUATION $ �C>e-(J
databaso _
Mechanical Name _ NE_W_CONSTRUCTION ONLY: _
Sub- Sq. Ft. House: �Sq. Ft. Garage
Contractor Mailing Address
Prior to permit — Corner Lot YES NO Flag Lot YES r NO
issuance, a copy City/State Zip Phone (check one) (check one) -I
of all licenses Restricted Audio/Stereo Burglar
are required if Oregon Const. Cont Board Exp Oate Energy _ System Alarm_
expired inGOT Lic#
database Installation — Garage Door HVAC
_Plumbing Name --- _ _Opener — _ , 5ysterns
Sub- (check all that Other:
Contractor Mailing Address i--- apply)
Will the electrical subcontractor wire for all YES 1 NO
restricted energy installations'i
Prior to permit City/State Zip Phone
issuance, a copy Has the Subdivision Plat recorded? N/A YES NO
of all licenses are Oregon G7nst Cont Board Exp Date
required if Lic# Solar Compliance
expired in COT (Calculation_Attached)
database Plumbing Lac r Exp Date I hearby acknowledge that I have read this application,that the
information given is correct, that I am?he owner or authorized
agent of the owner, and that plans submitted are in compliance
with Oregon State laws
Electrical sign»fylr Byer/, nt
Sub- Mailing Address
Contractor Cant .'Per'son Nime Phone#
CityrState Zip — Phone h
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat#: Map/TL#.
of all licenses are Oregon Const Cont Board Exp Date f✓�q I I / 1 j-[�C -D.iG�'L`
required A Uc#
expired in COT Setbackks; Zone: Solar:
i` � � � A{
database Electrical Lic # Exp Date — �.
Engineering Approval Planning Approval TIF
I SFREM.DOC (DST) 4/97
CITY OF TIGARD m r� r r:r? F,1_7 I?M I T
DEVELOPMENT SERVICES r.,ERMTT #. . . . . . . ..
13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE Ic;93LJED. 09/2:vc)s
(''mcri. 101735T)C'071001
1 1151 f;w C.
LAI', ']Tntq. . . F T RDA[-,r-. ZON I 1q11 R-4. 7
01'." . 1_(?T. JOPIC-,I�T(7101N: TTO
Interior remodel
__-_-------------------------------------------------------- BUILDING ----------------—---—--------—-----—-----------------------
'SSUE: STORIES.......: I FLOOR BASEMENT_.- 0 !f 9SOUTRED SETBACKS---- REQUIRED----_-_..---_
`SS
EOUIRED-------------
`19 OF WORK.:ALT 4ETGHT.......... 0 rIRST._- 0 5f GARAGE.....: 0 sf LEFT,.........: 0 ME DETECTRSi
T OF USE...-SF FI"Sit LOAD....: 40 SECOND...: a sf CRON-1......... 0 PARKING SPACES:
'IS OF CONST.;5N DWELLING UNITS. 1 FINBSMFNT: 0 sf RIFT.... ...... 0
'UPANCY GRP.:R3 BDPI; 0 BAN: e 70TAI------- 0 sf VALUF..t- 12000 REAR..........: 0
---------—--------------—-----—- PLUMBING -—--—--—-—----—-------------------------—------
*S,........ 0 WATER CLOSETS,: I WASHING MACK.: I LAUNDRY TRAYS.: I IAIn GRAIN ft: 0 TRAPS.........: 0
'VATORIES.... I DISHWASHERS...: t FLOOR DRAINS..., 0 SEWER L14F ft: 0 SF RAIN DRAINS: 0 CATCH BASINS—: 0
UB/SHOWERS...: 1 GARBAGE D13p.." P WATER HEATEPE.,, 0 WATER LINE ft: 0 Br.KFLW DREVNTR! 0 GREASE TRAPS.,: 0
OTHER FIXTURES: 0
--------------------------- fF,CHAN I Ck -------------------------------—---------
;7UEL TYPES--------- FURN f 1W 0 BOIL/CMP 1 34P, 0 VENT FANS....,: ? CLOTHES DRYERS- I
E FURNI W, 0 UN!T HEATERS..: 2 MODS.......... 0 OTHER UNITS—: 0
'PY INP,: BTU FLOOR FURNACES: 8 VENTS.........: 0 WOODSTOVES.... 0 GAS OUTLETS....- 0
- ELECTRICAL ----------------
UNIT--- ---SFRVICE/FEEDER----- ..._TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADTL INSPECTIONS--
I
NSPECTIONS—I SF OR LESS: f 0 - 2" alp.. 0 P 200 alp..: 0 W/SYC OF FDR..-. P DUMP/IRRIGATION: 0 PER INSPECTION: 0
AWL 500SF,: @ 201 - 480 alp.. 0 NI 400 asp.. 0 1st W/O SVC/FDR! 1 SIGN/OUT LIN LT: 0 PER HOUR.,,,.,; 0
,,ITED ENEPSY,. P 40' - 600 amp.. @ 40! 600 asp. P EA PDDL BR CIR: I SIONAL/DANEL.--- 0 IN PLANT,
HM/SK/FDR.- 0 Got - low amp,: 0 601+alps-1M 0 41MOR LABEL -10: 0
1000 alp/valt. ., P PLAN ITIVIEW SECTION ------__---.---------.._--..-._-_-_.
Reconnect only.: 0 1z4 RES LINITS.., SVC/FDR)-225 A.: 1 600 V NOMINAL- CLS AREA/SPC OCC:
-_- _------_- ---- . ELE[Tql7k - RESTRICTED ENERGY -----------------------------------
A. SF RESIDENTIAL-------------------- ------ B. COMMERCIAL-----------------------------------------------------------
WDIO I STEREO.- YACJJ,.�M cYCTFV. RUDIO I STEREO. FIRE AIDPm...... INTERCOMINGING: OUTDOOR LNMC
BURGLAR ALARM..: OTH. BOILER.... HVAC.......,.... LANDSCW.VIRRTG: PROTECTIVE SIG,_
GARAGE 0ENFR.. CLOCK,....,.....: INSTRUMENTATION: MEDICAL,.......: O1HR: :
HVAC,,...,.....: DATA/TELE COMM., NURSE CALLS.,..: TOTAL # SYS7, Ml�
Owner: —--------Contracto,: TOTAL FEES,.$ 300.02
JACMIE RANG LAMBERT, LEROY LARRY This permit is subject to the rejilations contained in
11551 5w GREENBURG RD 3031 SE 1201H PVE Tigard Muricipal Codu, State of Ore. Specialty Codes an:
TIGARD OR 97223 PORTLAND OR 97266-I057 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Vhofle #: 211-4137 Phone 1: 93-7El-?986 not started within IN days of issuance, or if the work
Reg #..: 123698 suspended for more than IN days, ATTENTION, Orpqr- li!v
req,Ares you to follow rules adopted by the nret,
4otificat on Center. These rules are set fortein OAP 952-0114010 through CAR you say obtain copies of these
lirect questions to OUNC, by calling (513)246-1987.
---------------—----------------------------------------- KOUIRD IM.rTTONS -------------------------------—-----------------
11?chanical Insp Shear Wall Insp Building Final
.-I 4*b Top 91A 11 511110ion Insp
t-I.Pctrical Spry, Electrical Final
1.pctri-al Rot;, Mechanical Final
Inspl,
i
i
CITU OF TIGARD Residential Building Permit Application Plan Rec'dBerk# -174
13125 SW HALL BLVD. Alteration - Interior Remodel Only Recd
Date Ree
cd - � -
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. L—
V 503•-639-4'171 ( I/1► Date to DST'I-
F
F 503-684-7297 �'��^�� Permit# `3C '(7
Print or Type Caned
Incomplete or illegible applications will not be accepted
Name of Project Name
Job -Oacbi►e, i-_NU_NC. Architect Mailing Address
Address Site Address
i i ssi SW k669BU12 Cd. I --- -
CitylState Lip Phone
Name
Name
Owner Meiling Address n
I IS51 51 4 U F� Engineer Mailing Address
City/State Z��Ipp Phone
p Y
_. R��� City/State Zip Phone
General Name
Contractor Lq- Describe work New O Addition O LfAlteration K Repaid
Mailing Address to be done:AVP Alrw 1146;6ef�'01 �A�►
Prior to permit / /i�� Additional Description of Worlt1_�
issuance,a copy CitylState Zip Phyge 0 �•i ,: Mk111 a rcti' T1+r —1c Mo06
c r
of all licenses /z
�][•I-Dyd�j C ADD wrrCWS� f*� �w•, � X71.
are required It Oregon Const.Cont.Board Exp.Date PROJECT
expired in COT Lia# + VALUATION
_database_
Mechanical Name — NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: Sq. Ft.Garage
Contractor Mailing Address
Indicate the restricted energy installation by the electrical
Prior to pP,rnllt
issuance,a copy City/State Zip Phone subcontractor in the followin areas
of all licenses Restricted Audio Stereo
are required if Oregon Const Cont. Board Fxp Daie Energy System Alarms
expired in COT Lic# Installations Vacuum Irrigation
database System
Plumbing Name (check all that Other
Sub- a I
Contractor Mailing Address L _ Corner Lot YES NO Flag Lot YES NO
[Hals-11he
check one ;:heck oneEYES
�S Subdivision Plat recorded? N/A NO
Prior to permit itylstat Zip Phone
issuance,a copy 7 e /V �f�' oh
Solar Compliance
of all licenses are bregon Const.Cont.Board Exp.Date (Calculation Attached)
required if LIc.#
expired In COT -U i� F 7 1 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 laws.
Name Signatuf of Ow /Agent elk, Dat r
Electrical _' �` - ' �
-1111,
ontact PAF on Name P one#
Sub- Mallirg Address n
r
Contractor FOR FFIC_E USE ONLY: _ }}
City/State Zip Phone Plat#. Map/TL#: — I
Prior to permit
issuance,a copy Setbacks: Zone: Solar:
of all licenses are Oregon Const Cont.Board Exp.Date Nn fit
if Lic.#
expired in COT Engineering Approval: Planning Approval: TIF �n
database Electrical Lic.# Exp. Date
7 I SFREM2 DOC(DST)8/11/98