10335 SW JOHNSON STREET-1 f�
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Plan Che"t
OF TIGARD Residential Building Permit Application aucaSy
3 SW HALL BLVD. New Construction Additions or Alterations 0.118 pec:1—
-�rRO. OR 972:3 Single Family Dtetached/Attached (1 or 2 units) Cale a a _
i ::9–:1 i 1 Date to :ST
Print or Type permrt s
Incomplete or illegible applications will not be accepted Cattail
Names �r?•eiae:
Architect ,,,ng,1caress ,
Job
'address I '-a Aaaress _ Cay/State Z10 I Phone
Name Nam"
Owner '.tall ng Puaress Engineer etn9 Aca(ess
.State _ o 0.10 -e CaylState up Phone
3enteral I Name CescnCe wcrx New O Acd uon O alteranan O Repair
e done �
ntrac'or (�,/.(„t% (: to : rype of use )
,a ltsuu+se Madinq Addrttss /,
learn must I/n//.�G,%L._ nw_
1-00 4W C. jrwe Lo Plans rYW of Construction
!`TiCLYs
Occupancy Claaa
e e*tonneuon Cregan Const.Cont. Board I c.t Eco. Oate
x COT
�Ndl t Ce spnnhlered'y Yell] NOC
Ita:asetI CCT Business "ax or Metro i _xp. Cate If Yes, separate FI.S puns and
aoclication to be submitted
-hanieal Nww Number of Slorves
Sub-
-�ntractor
-- Proposed Use
,t,ctnt must Previcus Use
><owM
VALUATION $
"WILS"for
T am barn) '� ' ��4� t NEW CONSTRUCTION ONLY:
BUILDING IDT
'lumbing
j
Sub- fG/` L ' Unit T � _ _Sduare Ft tot units
�_� Y
ontractor 8)— '
'a.to I
wC.cx+t must 4_C i
:rweee au / D )
Wil the+iec:ncat succ.3ntrar-or wire for atl esinaeo
verses � C�l���`ll.i�e l Lf� f Yes I No
erergy�nstai!a:tens'
Has'me SUC:IVil;q n Plat recortec' i NIA I Yes I No
I nereby acstnowleage that I .-ave read:hits aepticauon• that the
rfcrrancn ;r:en :s =r=zv. .:at I am 'he :weer cr at::hcnzed agent of
]ctrical I .Name _ :he owner. arc that clans suCmit ed are :n Ccmclianre wio Oregon
Sub- 5ta A
ntractor .tautnC� Acor Si Vature IA nt TJ3i r
c' N..:r t0 issuance I --
1 Contact P on Name Phone
dr;.must C„y�Sta:e Cb, I ?hone
/?�
`vKe s� I l
_ntrac:n eso c - - -- - FOR OFFICE USE ONLY:
Cr n ns anti 3 rc _.ca I .xp. Cate
Ke^ses
r�r-a^on Map/ Ut I Zane
w
V ==T Eec .cat'_tc. s I cxp irate
am:ase) Engmen9 AppmiWTIF
Planrtutq
COT Business Tax :r Metre a 1 =x� Case - ( Approval •' . `:.. _
s:;es arp cx 11199 /
❑yil_ i ,Uta
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NIST. Permit (BUILD)
Plumo. Permit (PLUMB)
Mech. Permit (MECH)
ELC,1ELR Permit (ELPRNIT)
State Tax (TAX)
ti Bldg:
Plumb:
Nlech:
ELC/ELR:
Plan Check
MST: (BUPPLN)
Plumb: (PI-MPLN)
Mech: (MECPLN)
r
CDC Review - planning (CDCPLN)
CCC 'Review - bldg (CDCBLD) —
__ Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSOC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQI,'AL)
Water Quantity (WQUAN"r)
Erosion Control Permit (ERPRM.n
Erosion Planck/USA (F_RPLAN) i
Erosion PlanckJCOT (EROSN) -- —
Fire Lire Safety (FLS)
TOTALS:
1.'Cst3',M120V.00c rev. '(,m
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February 7, 1997
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Homeowner
10335 SW Johnson a
Tigard OR
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RE: 1995/1996 Storm Damage
Permits and inspections help to ensure that work is done in compliance with minimum
code requirements. Inspections are intended to protect the occupants of buildings and
current or subsequent building owners. If the work has already been done, we can still
inspect it for compliance with code.
4
On January 2, 1997, yca were mailed an application and instnictions, along with a letter
stating you had not obtained a Building Permit for repairing storm damage.
As of thio date, we have either had no reponse or an incomplete response from you.
ALL FEES WILL BE WAIVED FOR BUILDING PERMITS TO
REPAIR STORM DAMAGE.
Please contact DEVELOPMENT SERVICES at 639-4171 ext. 304 within 15 days.
Thank You,
Jill Aldrich, Customer Service Manager
Development Services
jcanne/g1(mn2
JMM
Wilwo
., „ ... .,
CSTY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rer.-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Sus . Ceiling Spank. ugh in Appr/Sdwl `
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line Bldg.
Plbg, Underfloor Rain Drain Fra ,ing -Plumb.
Alarm Water line Insulation -Mech.
Undertlr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested: / Time: AM PM ■
Address: /C)J.3 S S'`tom' 17"1
Builder: r Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: r�r^� _ p r
T� s f C- � Date:
__APPROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE
Call For Reinsp.
,, .
tlI{,ty,
�RjJ, •H«Me mss.,..._..._......W/lwiw.wn«.......n.n n« r,.r...wur hrtn.Y14'Pe YR4 a 4V "'%4h' \•^,.1 Y:
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City of Tig i Oregon
°F Rapid Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RATING: (Chet*one)
Name: _. INSPECTED(Green) ❑
Exterior only
Address: Exterior &Interior
— LIMITED ENTRY (Yellow) Q
No.of Stories: L UNSAFE (Red) N
! Basement: Yes ❑ No ❑ Unknown ❑ '
j INSPECTOR:
— ._
! Primary Occupancy: Dwelling LJ Inspector IU 0Affiliation
J Other Residential ❑ Commercial ❑ Office L)
Industriai ❑ Public Assembly ❑ School U INSPECTION DATE:
Government ❑ Emer.Serv. ❑ Hospital Mo/day/year
Ll
Time —� � am pm
Other
i
Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2; 3, or 5 is grounds for
posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY. A "yes" answer to 4
requires posting AREA UNSAFE and/or barricading around the hazard. Hazards such as a toxic spill or an
asbestos release are covered by 6 and are to be posted and/or barricaded to indicate AREA UNSAFE.
1 Condition Yes No More Review_ _ _ _ Needed
1. Collapse,partia!collapse,or building off foundation ❑ ❑ ❑
2. Building or story noticeably leaning U tJ ❑
3. Severe racking of wall,obvious severe damage and distress ❑ U 1
A. Chimney, parapet or other falling hazard ❑ U ❑
5. Severe ground or slope movement press ❑ l! U
6. Other hazard present: ❑ U U 6
Recommendations:
i
U No further action required
U Detailed Evaluation. required (circle one) Structural Geotechnical Other _
U Barricades needed in the following areas: _
U Other:
�! Posted at this Assessment: Occupants Notified to Vacate Temp Housing Req.
U Yes 'J No U Yes U No U Yes J No J ?
Comments:
�' __. - 7 ._�_.�_ '..s=t' ti' ,rte c��G t�•��_ � ------ ---
Estimat Dama�U 0% Cl 25% ❑ 50% ❑ 100%V--
OFFICE USE OW-Y
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INSPECTION NOTICE
City of Tigard Building Departwent
13125 811 Ball Blvd. Tigard, Oregon 97223
Instrction Line (Rec-O-Phone): 639-4175 Business Phone: 539-4171
InPpectiont---
i /
Footing Plbg. derelab `-K6ch. Rough-3li Appr/Sdwik
Found. Plbg. Top Out Gas Line , FINAL,
Post/Beata Struct. San. Sewer Framing -Bldg.
Po• c/Beam Mech. Hew ^rain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. -Hach.
Date Requested:- Time: AM PM
r •
Address: ) .J Permit 1:1's
Builder_:
THE FOLLOWING CORRECTIONS ARE RRQUIRED:
ol—
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A 02,0
,
Inspector, _ Dates
I/17
/�kPROVEO DISAPPROVED APPROVED SUBJECT TO ASM
Call For Reinsp.
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MECHANICAL_
CITY OF TIGARD
r-)F:.RMI T P.
PERMIT #. . . . , . . ; MEC94-0
COMMUNITY DEVELOPMENT DEPARTMENT :=:�::
13125 SW Hall Blvd.Tigard,Oregon 97223.9/dg '��03)i813g-4171 DATE ISSUED: 09/14/94
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PARCEL: chi 10e'BB•-00814
SITE: ADDREF 3. . . 103,35 :1W JOHNSON ST
ZONING: R•-4. 5
SUBDIVISION. . . . : BROOKSIDE PARK �
13LOCK. . . . . . " L_01 . . . . . . . . . . . ' `
CLASS OF WORK. . :P'EW FLOOR FURN. . . . : EVAP COOLERS: �
TYPE OF USE. . . . -SF SNIT HEATERS. . : VENT FANS. . .
UCC;l.11='(1NCY GRP. „ : R.3 VF- -S W/O APF'1_.: VENT' SYSTF-.MS:
STORIES. . . . . . . . . ? BOILERS/CO1v% RE::SSOR•_' HOODS. . . . . . . .
FUEL TYPES— 0—•3 I11='. . . .IDOMES. I IVC I N: �r� i:.
3-15 HF'. . . . : COMML. INCIN:
MAX INPUT: BT•U 15-30 FSP. . . . : REf-A 113 UN I rS:
FIRE DAMPERS')_ :: 30-50 HP. . . . : WOOD':;TOVE~S. .
GAS PRESSURE. . . : 50.1- HP. . . . : CLO DRYERS. . -
NO.
RYERS. . :NO. OF UNITS-------------- AIR F:A VDL I NG UN ITS OTHER UNITS. :
F'1_JRN ( 1.00K BTU: 1 GAS OUTLETS.
FURN )-•100K BTU: > L0000 c.fm:
Remarks : GAS I-URNGai':f
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Owner-: ___ _-- ._.........._......._... ....,_.... - — _..—..-----...__—...._-----_._.----• F E:ES
JON HEIL ty130 amount by date recpt
10,335 JOHNSON STREET PRMT $ 25. 00 JF 09/14/94 —
5PC:T $ 1. 25 JF 09/14/94 —
TIGARD OR
Phone #:
Cantr^actor: __•_____._________.________________
ARTS OIL BURNER SERVICE
7325 N CONCORD
i
PORTLAND OR 17117
Phone 4. $ 2:15. r5 TOTAL
Reg #. . 81709
__._...-.__.._._. REPU I REvD INSPECTIONS
— ----__.--
This pewit is issued subject to the regulations contained in the Mer_haritr_.al Insp
Tigard Municip..l Code, State of Ore, Specialty Codes and all other Final 1 n s pvc.t i on
applicable laws. All work will be done in accordance with
approved plans. This persit will a-pire if work is not started
within 160 days of issuance, or if work is suspended for sore
than 160 days.
Permittee Signature:
l:9si_led By : [�
L V
Call for" inspection — 639—•1' 175
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City of Tigard MECHANICAL PERMIT Planc!JRec #
13125 sw Hall Blvd. APPLICATION Permit # c
Tigard, OR 97223 ..,, �>` Z�
(503) 639-4171 £ w
escnpbon
Table 3A Mechanical Code OTY PRICE At IT
Job /f �� � 1) Permit Fee -0 .0 10.00 I /
Address v � � Q
-9,e_t.V4 d'L 2) Supplemental Permit 3.00
- Furnace o B I U-
4�,�.. •_ ) incl.ducts 8 vents 600 _
Furnace 100,000 BTU +
Ownef 2) incl.duds 8 vents 7.50
of umance
3) incl. vent 6.00
,ap*_ 6u seen )eater,w 4eater
4) or floor mounted heater 6.00
in I
Occupant ; 1 t2;^" u•,, i ,Il` ff,; y 5) appliance permit 300 I
----RepairDP o eating,re ng.
6) cooling,absorption unit 6.00
- 1 i er or comp, ea pump,au cono, —Y —
(_ 7) to 3 HP;absorp unit to 100K BTU 6.00
.y �«• — er or comp,heal pump,air conn
8) 3.15 HP;absorp unit to 500K BTU 11.00
Contractor , , i-Pr-or comp, ea pump,air con_ —
�C't� 9) 15-30 HP;absorp unit .5.1 mil BTIJ 15.00
,m. .y.�.Y„ •• • i or or comp, eat pumo,air conn
/ '7L 10) 30-50 HP;absorp unit 1-1.75 mil BTU 2".50
ere y ac ow ge a e r
vea is appTcahoon,'t)a e boiler or comp, )eat pump,air conu-
information given is correct,that I am the owner or authorized agent 11) > 50 HP;absorp unit 1.75 mil BTU 3750
of:he owner,that plans submitted are in compliance with State Air h an a ing unTt to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registr..6on — it handling urn
please give reason below.) _ 13) 10.000 CTM + 7.50
on porta e
14) evaporate cooler E 50
-- --went Tan ccrinected
15) to a single duct 3 00 _
—
Ventilation system not
16) included in appliance perinit 4.50
/y — --ooid servc�—
LyL 2- u 17) mechanical exhaust _ C50
esrn w new a ition U alteration U repairommerci7a n�m3ustnT—
to be done residential(D' non-residential p 18) type incinerator 30.00
xis ng use o rr // er,i.e.,woodstove,water
building or property.1
19) heater,solar, clothes dryers,etc. _4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property_
i 21) More than 4-per outlet
Type of fuel-oil Q natural gas �' LPG Q electric Q
_ --NaTTCL
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION --
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPFNDED OR
ABANDONED FOR A PERIOD OF )a0 DAYS AT ANY TAME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCFJ. --
TOTAL
Special Conditions — - --�---
Date issued by
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