10454 SW KENT STREET CD
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CIT Y OF TIGARD RI IILDING INSPECTION DIVISION
U L'
24-Hour Inspection Line: 9-4175 Business Line: 63.. .171 --
BUP
Date Requested - 2-- V AM FSM
— -- - BLD
Location Z U _SV 5 w /(�;/�- fy- i� Guuiite _ MFC -_--_
Contact Person ^- - 17Ir c '� rl Z - PLM -
Contractor Ph SWFl
BUILDING Tenant/Owner EL(;
Retaining Wall — ELF1 _—
Footing Access: —`
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes SGN
Slat
____._--_�------------ ---_---------- SIT
Po:. r'4 , _— --_—
Ex 3h.. #W".hear
Int Sheath/onear --- ------�
Framing -- -_---
Insulation __.---
Drywall Nailing -_-
FirewallI —-------- - -------- -_ _.-..---------------
Fire Sprinkler
Fire Alarm ---
Susp'd Ceiling —_-_--
Roof -- ----- -- __---
Mise: _ --- --- -- ---- -- — — -- ----- -
Final
P ass PART FAIT. - - — - ---- - - -- _---------------------
PLUMBING
Post R Beam �- ----- - - --------_ ----- --------- --_
Under Slab
Tr p Out - - ----- - _---- __----
Water Service
Sanitary Sewe, -
Rain Drains
__T..---------- —
inal
PASS PART FAIL
MECHANICAL
Post R Beam _---------------__ _.._,- _----_-_-,
Rough In
Gas Line - --
Smoke 0; Ip(;iC ------------._-- --
Fina! - ------.._.PAR-1 FAIL
FAIL
Service
Rough In _ -------- ---..___--- - ---- -----_�
UG/Slab
Low Voltage -` --'- ——
Fire Alarm
Fin ------
ASS PART FAIL
SITE — --------- ----
Backfill/Grading - - -- - - -----.
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next Inspiction. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f 1 Please call for reinspertion RE:— ( ]Unable to inspect-no access
ADA
Approach/Sidewalk Date �-"tJ Inspector ?'h�' Ext
Other -- _.
Final
PASS PART FAIL DO NOT REMOWE this inspection record from the Job site.
i
Permit* 11-ST 2-0 o O — G cV00
ol-
A, �, Address: K !Ly—
O
Issued b 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 t intractors 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 this statement. This statement will be filed with the permit.
Dill in the appropriate blanks and initial boxes 1 and 2,and either box 3A or 313:
I—] 1. 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
U before or upon completion. fo� �
E
A. My general contractor is WG �^ �` ta\-e'sS CG� ( o 7 l 72,(Name) Qo%-l5'�f Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
F] 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 :incl that I hay c read and do understand the 1 nforn►ation
Notice toPr ty s a of t Construction Respow il►ililie,, on the reverse side of this form.
t,' ature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
Information Notice to Property Owners
A'U,out Construction Respansibil1t6es
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CITY OF TICARD MASTER PERMIT
PERMIT#: MS12000-00100
DEVELOPMENT SERVICES DATE ISSUED: 04/14/2000
13125 SW Hall Blvd.,Tigard, JR 97223 (503) 639-4171
SITE ADDRESS: 10454 SW KENT ST PARCEL: 2S114BB-14300
SUBDIVISION: SWANSONS GLEN NO.2 ZONING: R-12
BLOCK: LOT: 084 JURISDICTION: TIG
REMARKS: Second story addition w/loft.
BUILDING
REISSUE STORIES: 2 _ FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 18 FIRST: 71 sf BASEMENT: 0 00 Nf LEFT: 8 SMOKE DETECTORS: 'e
I YPE OF USE: SFFLOOR LOAD: 40 SECOND: 71 st GARAGE: 0 s} FRONT: PARKING SPACES.
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: 0 st RIGHT:
VALUE: 00
CCCUPANCYGRP: R3 BDRW BATH: TOTAL: 14200 6t REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN. TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: Sr RAIN DRAINS: I CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFI In PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL _
FUEL TYPES FURN<10OK: BOILICMP<OHP VENT FANS: CLOTHES DRYER:
GAS FURN—100K: UNIT HEATERS: HOODS: OTHER UNITS.
MAX INP: btu FLOUR FURNANCES•, VENTS: 1 WOODSTOVF.S: GAS OUTLETS:
ELECTRICAL
RESIDE14TIAL UNIT _ SERVICE FEEDER_ _TEMP SRVC/FEEDERS BRANCH CIRCUITS _ MISI ELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FOR I PUMPIIRRIGAT10N: PER INSPECTION:
FA ADD'L 500SF. 201 400 amp: 201 400 amp: tet WIO SVC/FDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp 401 - R00 amp: EA ADDL BR C;R. SICNALiPANEL: IN PLANT:
MANU HMISVCIFDW 601 1000 amp: 601-ampsA000v: MINCR LABEL:
1000 amolvoll
PLAN Rt VIEW SECTION
Reconnect only.
=4 RES UNITS: SVCIFOR>=225 A.: >600 V NOMINAL: CLS AREAISPC OCC.
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIUENTIAL B.COMIIERWAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO B STEREO: FIRE ALARM, NTERCOM/PAGINO. OUTDOOR LNOSC LT
BURGL AR ALARM: 0TH. BOILER: HVAC,. LANDSC,APEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INtiTRUMENTA71ON: MEDICAL: OTHR:
HVAC: DATA1TELE COMM: NURSE CALLS. TOTAL N SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 498.15
This permit is subjectto She regulations contained in the
FIDDES, RUSSELL GORDON AND NORTHWEST WILDERNESS CONST
Tigard Municipal Code, State of OR Specialty Codes and
DEBRAH SUE 1412.7 SE 12TH STREET all othrr applicable laws. All work will 1,;:i done in
10454 SW KENT CT VA14COUVER,WA 986837007 accordance with approved plans This permit will exp re if
T IGARD,OR 97224 work is not started within 180 days of issuance,Or if the
work is suspended for more than 180 days ATTENTION
Phone: Phone: Oregon law requires you t0 follow rules adopter+:,y the
Oregon Utility Notification Center Those rules are set
Re0 N: LIC 107172 forth in OAR 952.001-0010 through 952-001,0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Footing Insp Crawl Draln/Backwater Framing Insp Plumb Final
Foundation Insp Fooling/Foundation Dr; Insulation Insp Final Inspection ORIGINAL
POSUBeam Structural Mechanical Insp Rain drain Insp Building Final
POsUBeam Mechanica Electrical Service Electrical Final
Undeliloor insulation Electrical Rough In Mechanical Final
Issued By : (�,�t1 =. Permittee Signaturei,L
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITY OF TIGARD Residential Building Permit Application Plan Cheek
13125 SW HALL BLVD. Additions or Alterations ReDate Recd cd By F,_���
/11*TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E -
V 503-639-4171 Date to DST� , 1J
F 503-684-7297 Permit# ' 1f;zaae- w/oQ
Print of Type called /.'41�
Incomplete or illegible applications will not be accepted
Name of Project Name
Job F—'r L"ti� ,k'A — Mailing Address —
Address Site Address Architect g
----_-_-- _JQLJ6'- =-��L City/State Z,p Phone
Name
Owner Mailing Address Name
Engineer Mailing Address
Cit/Stare1 Zip Phone
City/State — Zip Phone
General Name
Contractor I` "Ltr' c`^1!`c� �f Describe work New O Addition Alteration O Repair O
ailing Address to be done
Prior to permit `0� Additional Descr�ptic}r1 of Work:
issuance,a copy City/State in one S�� ly 7 _-21 :5
of all licenses
are required if Oregon Const Cont Board Exp. D to Q PROJECT
expired in COT Lic.# j �� �L ,
database CT VALUAT.r ON $ 73�) — _�—
Mechanical
Name� l� NEW CONST_RUCTI ONLY:
Sub- UWvt,c�_.(;7.;,��y, � �� Sq. Ft. House: — - Sq. Ft. Garage
Contractor Mailing Address
Puor to permit L i Indicate the restricted energy installation by the electric,-'
-2-1p
--- - subccntractor in the following areas _
issuance,a copy i /tet to Phone --of all licenses �
Restricted Audio/Stereo
are required if Oregon onst Cont Board Exp. Date 1 Energy S stem,-- Alarms -
expired in COT Lic it \ I Installations VacuumIrrigation
database _ _ �-y \_ System — ]-System___i
Plumbing Name (check all that Other.
Sub- _"P
ti'' (�X,�^ t�� 'c� Y• "per--
Contractor Mailing Address Corner Lot YES NO —Flag I_ot YES NO
(check one) _ (check one)
v :-��� Has the Subdivision Plat r-corded? N/A YES NU
Prior toermit City/ tate Zi Phone 1
issuance,a copy _4, i� 1C171>Ll_ 6.3t(-�� -
of all licenses are Oregon Const Cont Board Exp-bate
required if Lcc.# — —
expired in COT I hearby acknowledge that I ha•:c read this application, that the
databaso 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
Ore n tate laws
_ Name — -- nnSign eent t
ew
Electrical Owv�e�` n �ti '�I -- - Va""`"..------ _-- 1
55
--�---- --��- Contact Pers Name Phone#
Sub_ Mailing Address L r
Contractor �- *„�.�-• �' ST�Jc Cw) ��l.�l..�!�V`,, _.._-_�_' '�'G_�G "
City/State Zip Phone
Prior to p?rmfl r�
issuance,a copy ,*n14y� ` ` � " _FOR OFFICE USE ONLY:
of all licenses are Oregon Const.Cont Board Exp Date plat#: M:pll L# "j,
-� —
required if Lic# f . lel 0 CA
expired in COT _ __ ___�_—as! J
database Electrical Lic.# Exp Date S �..
et cks: Zprip� --- Solar:
Electrical Supervisor Lic # Exp Date Engineerin�roval Planning Approval: TIF:
i\dsts\tormsWaddalt.doc 11/18/99
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