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/1 ----- BUILDING PERMIT
CITY o TIG
�a� PERMIT #: BUP2002-00149
DEVELOPMENT SERVICES DATE ISSUED: 5/8/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-14100
SITE ADDRES): 12303 SJV KING GEORGE DR
SUBDIVISION: KING CITY NO 5 ZONING:
BLOCK: LOT: 01�) JURISDICTION: KIN
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: AL I FIRST: sf N: S: E: a W:
TYPE OF USE: S� SECOND: sf _ PROJEOT OPE ?
TAPE OF CONST: 5N 5f N: ^ S: !_: W:
OCCUPANCY GRF: R3 TOTAL AREA: 000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RAI ED:
BSMT?: MEZ7?: _ ^LLD SEI BACKS _ _ _ REQUIRED
FLOOR LOAD: psf LEFT: ►t RGHT: ft FIR SPKL. _ SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft F;R ALRf,1 : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR• PARKING:
VALUE: $ 2,000.00
Remarks: Enclosing Patio with 3 walls no heat, electric or plumbing
-
Owner: Contractor:
SCOTT, SANDEE MICHELE RAM SERVICES, INC.
12303 SW KING GEORGE DR PO BOX 231061
KING CITY, OR 97224 TIGARD, OR 97231
Phone: 503-443-1965 Phone: 503-590-7269
Reg#: LIC 66997
FEES i 2EQUI"ED INSPECTIONS
Type 3y Date , Amount Receipt Framing Insp +
PRMT CTR 5/8/02. $62.50 27200200000 Final Inspection
5PCT CTR 5/8/02 $5.00 27200200000
PL,K DLH 4/29/02 $40.63 2002-1552
Total $108.13
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
.nd all other applicable law. All work will be none in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTEI(TION- Oiogon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules ares set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct quest ons to OUNC by
calling (503)246-6699 or 1-800-332-2344.
Pe nr ittee
Signature: !Y/ r 'e, L
Issued By:
C^II 639-4175 by 7 p.m. for ao inspection the next business day
Building Permit Application
- -- _ Daiereacived: 74 Permit no.: ��
City of Tigard - �_
t'roject/dppl,no.: F.xpiredate:
City ofTigard Address: 13125 SW Ball Blvd,Tigard,OR 97123 1 — "__1
Phone: (503) 639-4171 r,iu issued: ByrReceipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&.2 family:Simple Complex:
C3 1 &2 family dwelling or accessory U Commercial/indu-.:r.al J Muln-fainily J New construction U Demolition
KAddition/al Iteration/replacement U Tenant improvement U"ire sprinkler/a,.rm U Other: C
t t
Job address:1 Z aj 3 ��._.) IC Suite no.:
Lot: Bloch: Subdivision: Tax map/tax lot/a -it no.:
Project name:
Descrirtivn and location of work on premises/special conditions:,_i-C L-4%5s fit- _P�tT�a k f n {, 111►_F_
g/C yw tt i(
'rrtik. �C T C_LCJ
KU HM
NNar.lc: 7 � coTrr,—,., ,
— -----
_Ming address: 17 5,;;) -j K t� �4� 4 _ 1 & 1 fantilr dwelling;
C,tY: C:e Statc: cr-A ZIP• -...�.z. t-y Valuation ofwork........................................ $.__�
Phone: 3 ;, (,�'(t Fax: .-snail: No.of bedrooms/baths.................................
Owner's rept.^entative: Total number of floors.................................
Phone Fax: Ir-mail: New dwelling area(sq. ft.) ..........................
Garagr/carport area(sq. ft.)......................... _
Nan,c: �` f�� C CK �l ti4+n 54rcv,c Ls Covr,rcd porch arca(sq. I't.) ......................... -----
_�.
Mailing address:&j4. � 310 f)%ck arca(sq. ft.) ........................................ �.
City: 7` State:LA ZIP: c. ?;Le, Other structure area(sq. ft.)......................... _
Phone: CFax: E-mail: ('ommercial/Industrial/mufti-family:
Valuation of work.............................. .........
Business name: Existing bldg.area(sq,A.) .,-,`.....fr.........
Address:
-- New bide.area(sq. ft.) ..........
/3 , k - 5 r U G/
City: 77l State: o1A 'ZIP: Cr2? Number of stories............`....... .............
rypc of construction........ .... ................ -
1'lume:, a ).Z� Fax: E-mail:
Occupancy gro p(s): L'xisting: _
CCB no.: 41(1y 2 — New:
_
City/rnetm tic.no.: r4�?a, t `rte tf=yrt Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contr.,ctors Board under
7ne provisions of ORS 701 and may he required to be licensed in the
urisdiction where work is ficin erformed. If thea licant is
J g p pp
City: State: /.I1': — exempt from licensi.lg,the following reason applies:
Contact person: Plan no,: —
Phone.- Fax: E-mail:
Name: Contact person: Fees due upon application ........................... $_
Address: Date received: _
City: _ State: 7_'P: Amount received .........................................
Phone: Fax_ E•nrail: , Please refer to fee schedule. _
hereby certify I have read and examined this application and the Not all Jurisdictions accept credit cant,please call jurisdiction fix mrxe info i;at -
attached checklist. All provisions of laws and ordinances governing this U visa U Mastercard
worts will he ccrnnlied with,whether specified herein or not, Creeit can number
Expires
Authorized signature:/'C_ - 5 Date: �L Name of cardholder at shown on credit card
Print name: _._-� $
Cwdholder sipettre _ Amount
No,.ice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 440.4613 rntorvr'oM)
!„
to /
One-and Two-Family Dwelling .�
Building Permit Application Checklist Ilcferencs
City q/Tigard City of Tigard Associated p,rm!ts:
Address: 13125 SW Hall Blvd,TU Electrical J Plumbing LIMechanical
OR 97223 OOcher:
Phone: (503) 039-4171 ----
Fax: (503) 599.1960
I Land Ilse actions cornpleted.Scc jurr.�f action criteria for camcurrenl rc•.as 1
2 Coning. Flood plain,solar balance points,seismic soils designation,histone
3 Verification of approved plat/lot.
4 mire district _ approval required.
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit. �-
7 Water district approval. _
R Soils report, Must carry original applicable slump and signature on file or wuh appli,:ation. —
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence-design and location of
catch-hasin protecion,etc,
10 J Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must he incorporated into the plans or on a separate full-sire
sheet nitached to the plans with cross references between plan location and details. Plan review cannot he completed
if copyright violations exist, _
I Sitelplot ,Ian dram-„to scale.The plan must show lot and building setback dimensions;property comer elevations(II'
them is mune than a 4-11.elevation differential.plan mu t show contour lines al 241.haervals):location of,asenu•al.s and
driveway;footprint ofstructure(including decks);I(nahor,ol'wells/septic systems;utility hIcalions;dime 1011 inaficntor;lot
_ area;building coverage area;percentage of coverage;impervious Irma;existing Shtictums un Site,and surface drainage.
12 Foundation plan,Show dimensions,anchor bolts,tiny hold-downs and reinforcing pads,connection details, vem
size and location. _
I i Floor pians.Show all dimensions,roolli idencifiratiom,window size,location of smukr delectors.water heater, -
furnace, ventilation fans,plumbing fixtures,balconies in(]d-cla 10 inches above grade,etc.
III (Tugs section(s)and details.Show all framing-mcmhcr°izes and spacing Such a,,floor h anis,headers,joists,sub-flour,
wall constntction,roof construction. More than on, '-rocs section nay he required to clearly porllay construction.Show
details of all wall and roof sheathing,rooling,roof sl Inc,ceiling,height,siding material,fernings and foundation,stairs,
fireplace construction, thermal insulation,etc. _
IIS Elevation views.Provide elevations for new cowInlclion: minim.un of Iwo els%ati0n;for addition.and remodels. --
Exterior elevation! must reflect the actual grade it the change 111 grede is greater Iha11 firm 1001 at building envelope.
Full-size sheet addendurns Showing foundation clee_ui rte• %N 11b cross references are acceptable.
I h Wall bracing(prescriptive path)and/m lateral analysis plain, Must indicate details and locations:for
_non prescriptive path analysis prm pecific tions and calculations to engineering standards.
1-7 Floor/roof framing.Provide plans for till floors/ro�d�assenmbl ees,indicating 11a(•111her sizing,spacing;,and hearing
_locittions.Slmuw_altic vetctilation.
19 Basement and retaining walls. Provide cross sections and delails showing pi,1,oment of rehar. For engineered
systems,see Item 22,"Engineer's calculations."
I9 Ream calculation##. Provide two sets of calculation;using current code(design values for all beams and multiple,joists
over 10 feet lung and/or any hearn/joist carrying it nun-uniform load.
NF Manufactured floorlroof truss design detalls. __ ----
I Energy Code compliance,Identify(lie prescriptive path or provide calculation% ,4 gas-piping schematic is require(]
foe four or more apptian(es.
22 Engineer's calculations.When required or provided,(i.e..shear wall•rool'ti n •shall be slumped by an engineer or
architect licensed in Oregon and shall he shown to he appocahle to the proico i ii ler review.
1
23 Dive(5)site plans are required for Item I I above. Site:plans must be X-1/2" x 11' or I I" x 17".
24 1fwo(2)sets each tire required for Items 16, It),20&22 ahove.
25 Building plans shall not contain red lines or tape ons. "Mirrored"building plans will be nut accepted.
26 "Reversed"building plans must nieet criteria outlined in the Permit& System Development Fees document.
27 "Drawn to scale"indicates standard ttra:i,u l or engineer scale. El
28 Site plan to include free size,type&location pe. approved project street tree plan(if applicable),anti CO'f Strcct'free List
Checklist must he completed before plan review start data Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440461416rt1IartConu
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DING CITY $ .... .. .
0300 SN 116th.Avenue,King City,Oregon 9713,.04$693
Pnone:(503)639.4092•RAX(503)639.3771
Notice To Contractors Working In king City
Due to an intergovernmental agreement with the "itv of Tigard, many building related nits
for projects in King City are issued and inspecteL. by the Citv )f Tigard.
If your permit application DUES NOT REQUIRE PLAN REVIEW. simply complete the
appropriate application legibly and submit it to the King City staff. 'The King Cite staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit. and perform inspections. Please indicate on the pen-nit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete. legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simple sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at l: 125 SW
Hall Blvd. Tigard, to submit applications and plans. Development Sen ices Technicians are
available at 639-4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit 'ees will be assesse 1 and collected at the City of Tigard.
The City of Kine City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: r"�Li.) Gy. LI --, (�e-,2
located at:��.�1
King City Representative 7- 0.2--
1
.2-I DST Kr, i7 DG,"
CITY OF-TIGARD 24-Hour
BUILDING Inspection Line: (50s)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 / MS
Received Date Requested_— AML_��S PM—_ BUP
Location �— -'�G_,� - Fite MEC -_
Contact Person Ph( r/ ) PLM
Contractor_- _-._-_,_ Ph( ) .__,._ SWR
BUILDING Tenant/Owner ELC
Footing ' ELC _
Foundation Access:
Fig Drain EI•R
Crawl Drain SIT
Slab Inspection Notes: -~ -- --
Post&Beam — _� -_ � •'� 0-"`��_c
Shear Anchors ----`-
!". J G I LrC c'
Ext Sheath/Shear
Int hath/Sh�ar
Framing - �� - �.,�,
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm s (� 5-�.-. t ��Q.�T"'�'v GN -s
Susp'd Ceiling �-
Roof
Other: --- ---- - - .'`-
1=i
ASS PART FAIL --�
PLUMBING _ - _\� -
Post& Beamn I
Under Slab _. _ v��,�,� - 15tZ.-4 _S �N�` -.1� `�, _•
hough-In --
Water Service _
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain - — -- - -- --
Shower Pan
Other. ------- - --
Final r � rl
PASS PART FAIL
& HANICAL
Post a3 Beam
Rough In ---- -- --- -- --- .- '.�---e_ —
Gas Line
Smoke Dampers
Final
PASS PART FAIL -_----- - - - - -
ELECTRICAL-�
Service
Rough-In ------- -- ------ ------
UC/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of$_ ____requued before next ins;_action. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - [� Please cell for reinspection RE:--- _--_______ Unable to inspect-no access
Fire Supply Line --7 , /
ADA I,,/'� �'L / -� C__ Y 2
Approach/Sidewalk Date mac{--� _ " __ Inspector__-__ �-!� __ -, Ext
Other:
Final - - - DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
/ CITY OF T MECHM]T 1 .l_
DEVELOPMENT SERVICES PFRMIT
13125 5W Hall Blvd., Tigard, OR 97223 (503)539.4171 r'F"RM I T #. . . , . . , : ME:C�7 -•�y
)FI): 10/;:'71197
r'ORCEL_: cC 1 i OCC--14 102
^IT1r (�DDREr:': . . . iino- SW i IMG r;r'nr r.— r-
UPDIVTCICIN. , . : VMG CIT't' h•In, r 70MINr:
nLnCK. . .. . . . . . . . : L C:1T. . . . . . . . . . . . . .019 RT"DICTION:
. I�
'3'TC7IClN T1I
CL.ncs OF WORI', . :OTR FI.0C1"' r`'.IPN. . , . : 0 CVnP CnnLERS: 0
TYPE OF' UGE. . . , :GF UNT +TFRG. . : Qi VF.t�IT F0114^. . , : IZr
rlf_Cur'r?NCY GRA', . :; R-: VEt!_, n nr'r'L : 171 VEh17* 5Y73TF"M17): 0
TnRiEs-). . . . . . . . . Qi POT LL. HOODS. . . . . . . . .0
rUE I. TYPr r.._...... .... .. . ._.._ . i;-�....7, 1.,r, : 0 =11.7"11. I NC T M' Vr
-•1.5 Hr"'. . . . . o COMM!_... I Nr I N: 0
rlAX 1KNAT: 0 PTU 1.5 30 Fir'. . . , a 0 RP'nTR 1.JhiTT'=1" 171
r-I RE DO Mr'ERS?. . : 30--50 HF''. . , . : 0 WnO177)TOVEr?. . : m
GAS PRE TM)URr'. HP. . . . 171 C:!..O PRYr7R,". :'!
'�O. OF' LIt\ITTC - - - nIR HnNDL_I1'JG UNITF; nT-AF"R UNITE. ';
R'l.1RN ( 100K PTU- 0 (:-f m : 0,
FURNsnj: o > tQ117f o I_'fm : 01
1,F Add ga, line to and existing single fasP y dwelling.
'JW r)a r.,
SANDEF" SCOTT tyt.)(! <:tIII o'.lr)t by
t2230,2 T;14 i%IKIG) GEta^rC DF�IVI.. r,Rh7r t ``,.. 00 cl!-,n ! 011' -7/1717 �ITW7 r..
'!INC CITY OR F172,2% •,, r.._ r r r,cn 1 - - 7 r-Th,rt-: r,7T
PI-1or)r ##
'ter) r•atr.�t;or : _
rL_TMOTF. CONTRr1:. 141,"()TINC1
:�.31r ixW ;Tr,TH ME
r nRTI.Arm, OR 7,17210
r'h o r)r, #- :'P3-4393
Reg V. . . 000006
REou I prD I r,I r,r-CT 10P49
his pereit is issued subject to the regulations contained in thr r)c.1,:; l„ i I IQ l'71!5 p
Tigard Municipal Cade, State of Ore. Specialty Codes and all other Mi Iir. . ITI .lP)eUt i.on
,applicable laws. All work will be done in accordance with P i n.al Trrspec:t i or)
)ppr•oved plans, This pzrtait Hill expire if work is not started
iithin 180 days of issuance, or if worn( is suspended for more
`.!an 180 days, ATTENTION, C.eyon law requires you to follow rules
opted by the Oregon !Jtility Notification ",oier, Those rule" are
set fort(' in OAR 452-001-0010 through OAR '-'52-001-0080. Ymj say
)btain copies of these rules or direct quer ions ;,c LPJNC by callirc;
r5031�46-91A�,
r, iri ) I 1
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OCT-23-197 THU 10:3, i[ : FAX NO: #553 P02
I r Qr I itaAr-.0 Ivltl:(ldlifl,dl r��f�tit "Npitcauon Rac'dBy 1 �
126 SW HALL BLVD. Cornmercial and i.Fsldential Date Rer.'d
BARD, OR 97223 Date fn P E
)3) 639.4.171, x304 Date to UST
Print or type Permit
c.�uHa
Incomplete or illegible applications will net be accepted --
risme of p«�wlnpmenVPmiwd Description -
Table 1A Mechanical Code (QTY PRICE All
Job n+or noorose saner A) Permit Fee t0
Address �Z'�p3 Sw KiQ/ e pe.
RHtpa r pyrstate 1 Lb, 85 Suppl• ental Permit 3.00
Name(oe��mo of W�Ineu, �`-7 - 1 ) Ft,irmace to I OU,000 BTU —
Owtler Inci,ducts 3 vents
Millin incl.duets 8 vents adnretir 2) Furnace 100,000 STU 7.50
4f1
ave Wo Zipthane 3.1 Flonr umer® 6.00
_._ T'�._� incl,vent
neetorrwneatoueiness) 4.) Suspe,ndedheater.wz,lheater
of floor mounded heater
m
')ccupant Mailing AMP.,. S) Vent hot incl.In
300
appliance permit
CIN/store" ',r, r.,... ( 6.) Boiler or comp,heat pump.air Gond. 8.00
to 3 HP.absorp unit to 100K BTU
Narne - 7 j Boiler or ramp,nest pump,sit tend. 11.00
Ll Air COM AC 3.15 HP mbsorp unit to 500K BTU
Ontractor Melling Addrena 3.1 Boiler or i:omp,heat pump,air Gond. 1500
33r S 15-30 HP,absorb,unit.5-1 mill BTU
'tach ropy of cny0.ram Zip mart 9) Bc der or camp,heat pump,air eons 2250
rent Licenser. D 0� n/0 2L3-n*3 iG•.J HP;absorp uni! 1-1.75 mil BTU
Oregon conk caurrffooWd ik: Elp.0 10,) aider or comp,heat 9 nn.air cond. -- - 37.50
�1E2 A _ /G 50 HP,absorp unit 1.75 mil BTU
GOT Susineu Tu or Mr4o a Erb, uete ;1 1 A ir handling unit to 1 `U
' A 10,100 CFM _
Architect NQMQ 12) Air handling unit 5b,
10,000 CTM
Ar ai ma rrree 1
) Non portabie 4.
evaporate cooler
1.refit
:nainNr 'M --- Lo vnone tq,l Vent fan Corroded 3,00
to a single duct
tribe work New O Addition O Aitaration O Repairx_ 15) Ventilation system not 4.50
e done— Residentlal re
Non- aidenlial p included in apphaice p-„rmil
dional Dscription of vborl, 16,) Hood served by ^-- -
mt;chanical exhaust 4.50
^ 17) Dorne5tic incinerators W 7.50
unq use o �� 18.) Commercial or industrial 3000
'mg ur pr,pc.'r type incinerator
19.) Clothes dryers,etc. 4.50
,used use of 20) other Unita — _ �J 4 50
ling of pmpery
of fuel•oil 0 natural gars LPG O electric O 21) Gas piping one to four outlets 200 2.�
?by ac nowlr-dgP that I have react mli a,5pllcation,that Me -'a' ) ZuTcre than 4-per outlet (each) 50
oration given Is=rrdd,that I am the owner or authorized anent of
,caner,that plane submftted am in compliance;with Oregon State QTY.SUBTOTAL
,ebve of Owner/Agent Dale •SUATOTAL
/C 31^'� tis;SURCHAPGE _
C �
,tact person iame Phnne I PLAN REVIEW 25%OF SUBTOTAL
._..TOTAL
nechpmt d(ir --_�J�1 'Minimum pertnft tees$25+556 surcharge