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Residential Building Permit Application
City of Tigard
13125 SW H. it Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Office Use Only
Subdivision: 'S t7lta Lot#
Contact Date 1 I Initials
valuat;.n: ¢ 0 ( �— — Result _—`—
New Construction Only: (Square Footcge) Planck/Pec # of 7 Cil
1 r .WWI Permit # _/,'15126
House: 1 Garage: F _ Reissue of
Map & TL;1' _bf
r
Corner Lot? Y CNSFlag Lot? Y '� // 7.one —
`� l� Plat # i I^ .
Owner. ,O�n/� �' �. —C�1S t
JG� App ovals Required
Address:
C Planning Setbacks t�, Solar
Engineering
/Fhonp _ ,��� L Other
items Reg !red
Contractor: ����� —
Subcontractors
Address Truss Details
Other
r7—e Notes PU f
Phone:
Contractor's License # _ �,M _—_ —r-7
(attCIA
copy of current Oregon lir;ense) � j�ti,to_ yIr;'iflhf�� 1/(° �C
Cc,ntart Name:
Contact Phone:
Subcontractors: ;` Arch itect/Engineer:
Plumbing: 1� d-� N� Address:
Mechanical �
(attach copy of current OR Contractor's License)
I
I Phone: L----�--- -----
JOB DESCRIPTION:
Applicant Signat� ure— —J�� -- Applicant Phone number -,
Received by: Date Received:
N veandnv.aoo 1
Permit # Account Description Amount Amt. Pd. Bal. Due
lh5 G Bldg. Permit (BUILD) _ y�. ,-7-1
Plumb. Permit (PLUMB) 2
Mach. Permit (MECH)
`X ) HGI, j' Lf L•.
Bldg: )-2, 2 y� -
Plumb: //- Z
Mach:
Plan Check ' (PLANCK)
Bldg:
Plumb:
,Sw�' UUSy Sewer Connection (SWUSA) c G .,
Sewer Inspection (SWINSP) _ a
Parks Dev Charge (PKSDC) S v G) 5
Residential TIF (TIF-R) /( _ 1 y 7V
Mass Transit TiF (TIF-'rIT)
Commercia TIF (TSF-C)
Industrial TIF (TIF-I)
Institutional TIF (TIF-!S)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQ(JANT)
Fire Life Safety (F'_.S)
Erosion Cntri Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) .;)V.lj-V
Erosion Planck/COT (EROSN) p •J-v ��tG
TOTALS: L I
2+05 2+00
p = 75'58'10" I--1
OR = 37.50'
LOT
L = 49.72'
7,602 sq.ft.
L ItaC
A
13311 $� - �
46'00'1 % _ \
QCC 1 w 0.1 Z
�
7,847 sq.f ►� �;�,,,,ti ao
l 5 `� titer`'�` 1� z
4
"AZ _
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�S� SET �j'1C1C C�,N1z�}� !`�`��'`�•��`{ �WIL I
0.34
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CITY GF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd,Tigard,Oregon 07223.8'09 (503)838.4171
11GS 7 WGR;.:v,: . _._ . ... ..,, c :: 744 s f GA?A'C. •... 437 sf LEFT,.........: 7 SKME DETECTRC.
7 USZ':...: FLGDR LOO...., 44 ZN&...s 75Z of FRGt+T.......... 20 MRKINs e,
"E�1O�F�LUtk+71, :Zti 1M .LING UNIgTS}�s i �F�ISNB 1+'Ts f 0 i'♦ �} r� RIIG11?........ : So-UPATC M.;r.' C.'v�*v l WI'.1�'1 i J YUTAL-.-....•..•Y 1 416 s r HL'.:,:..t; i 44,'l A XAR..,........ So
_.._..._.._... _ ... RLA-ANr ... . _..
rrATCR 7"aE�� : 3 w '11111% MACH, I LAI,:trV-! TRAtS9 0 W.N DRAIN ft: P
�T7R1FIS.... . 7;;"ViSt-ERS. .. I FLWR DRAINS..: 0 SIXR LINE 't; 2 SF RAIv DRAINS:
NER'-: A"1411 Dlrl '., : I WATCf HEATERS.! WATCR LIV ft: IN f4Cit1't. PRCMR: a
130i3W; t VENT 1r AN"o,...., t, CLO'XS NiiYCR$s I
... ., , :;�„ •. . � !M )EATEF''.,.. ...•...... 7'111, urs.T S.,.� I
r"J,i rV1NTS......
.... e GRS. 7ITt.ET�..,.
"'r.' C,'ta „•r rr,,iC'PrCE'Cr, TL SRBCf1'EEDER -
V, Sr 7 :C.7' :3 ^QE
nom.! Yap . a
;d�. asp... f 1 ktI 4 clap. �• ,
iA c.L _. .. . •. .., ,.�00 •3.s`✓r.. 42: SW 0ip.. w k' -. 1''.
aup,. x CO!'asp$ I D MTKR LAK 10: 0
%AN REVIEW SEV ION
Z )74 IES LNITS.. ,
;iT! 1'I77'r"..
s; X DLI,CR....,...., �C.. ...... .. . LAVDSCAPEIIRRIS. PRQ"+C
UATAITELE C01"i , ; 0717 CALLr..,.: Trrk
Ccr,tr.tC"•,. ?C'AL rl;Ca,,! 17M ,..
1 - -t{,1 .. . t`F •,. . ;tul�. .{ u':.-_, —:.sal`
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V. 41
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigar6,Oregon 97223*8199 (503)639-4171
7.ON'
UNI TC.
Ar". OF SUILI)INSS).
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00 BONI 0
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1.)3 (13, A7 15:uz $56.3 6's4 720T c:ITI OF TI(4ARD 002 002
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGA.RD, OR 97223
i
IMPORTANT PERMIT NOT.ZC: ,
JACK COE-MAN PLUMBING, INC
SE UAR GROVE OLVL)
MILWTevXZE OR 9726']
Plumbing Eig►natule Form
MST96-0041
Datr, IssUed. : 03/03/97
Parksl. . . . . . : 1912 SDA-11000
Si.t_ri Address: 06648 SW 9TN9FVTEV CT
Sutniiv.i:;ion. ; CRARLES EBTAl'ER
Hioc:k. . . . . . . . I,o L . 005
PATH I
Your company hAr, heon indiCatnd as thn plumbing cont►-a- utor for the permit ) ndlaa
for the plumbing hermit to be valid, please t.iave the mpprcpr.i_etab individual from
below and return this Plumbing signature Form prior to the start of work. No til
will be authorized lint i 1 this completed form is received.
AN TWX SIONATURN IB IalDQUIRED ON THIS FORM
QWN ER, PLUMBING (01TTRACT(71F
TOM ROGERS '.:U1VST. .JACY CORM" PLUMBING, INC
P 4 BOX 80152 2096 SE OAR GROVE BLVD
PORTLANI) OR 97284 MII.WAURIN OR 97267
Phone 0: 6a4-1193 p'nane #:
r" : C1. t .. U.! �1Ur'�1r i i l�� ' a•„t,4_t
Please. retu.n this complotod torr.► to the address .ii-,c!% -.
ATTN, Auildina Dopt .
If you have any questions , p-" ease call 639-41.71 , ext . 010
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STOCKMEIR ELECTRIC COMPANY
PO BOX 3175
GRESHAM OR 97030
Electrical Signature Form
Permit # . . . . : MST96-0046
Date Issued. : 03/19/96
Parcel . . . . . . : 1S12.5DA-CE005
Site Address : 06548 SW KINGSVIEW CT
Subdivision . : CHARLES ESTATES
Bloc:k. . . . . . . . kt ;t . 005
Zoning. . R-4 . 5
Remarks :
PATH I
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your corripany sign beiow and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received
AN INK SIGNATURE IS REQUIRED ON THIS FORM
ELECTRICAL CONTRACTOR :
TOM ROGERS CONST. STOCKMEIR ELECTRIC COMPANY
P O BOX 80152. PO BOX 3175
PORTLAND OR 97280 GRESHAM OR 97030
Phone # : 684-1193 Phone # :
Reg # . . : 011092
X _r2t� 1
Siyriature of Supervising �iectrician
P!3ase return this completed form to the address above.
A TN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY OF TIGARD
DEVELOPMENT SERVICES
25 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
CERTIFICATE OF
OCCUPANCY
FERMI T #. . . . . . , : MST96----0046
WITr ISSUEDi 10/28,/9C.,
PARCEL: IS125DA-11000
!'TE ADDRESS. . . : 06648 SW K1NG$VI1zw C ,
.BD IVISION. . . a CHARLES ESTATES
7011111 NG i P-4. 5
Ock. . . . . . . . . .
017 WORK. vNEW
Y'PE OF USE. . . %SF
+'PE OF' CONST R:5N
,jLt"'UPANCY GRP. # R,
-i
OCCUPANCY LOAI)ic�
1'?vmav-ksc PATH I
TOM ROGER[ CONST.
P 0 bOx 80152
PORTLAND OR 9*,.;?80
;'Ihonp #1 664-1193
Cunt r-art or,s ---
TOM ROGERS
�' 0 BOX 8015.2
11ORTLAND OR 97280
t-licne *t 452-872!j
95900
UrC:I.JP&rlc', Ell' the abuva r-efev,enned bt.tilding or pur,vion
;hetleof and col-Iffit,ms that the buildirly has been j.t,%jj(pctqd fat, c(.1mpjjar)crr will
F;he StAite of Lwepon Specialty L:Ccjps -"or tt.lp Ut.,0 t:-p cupant:y, alid uf�e unfiev,
which the t-efei-em;e(i pel-mit wmks js%�,F.m(j,
ni T. 1_1)I JSJ(3 I NSP11 (D 1
BUILDING OFFICIP!-
FAST JN COW-PICUOIJO PJ-ACE
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639.4175 Business Phone: 639-4171
Footing Rain Drain Coyer/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing Mach,
t
Plbg.Und/Flr/Slab Plbg, Top Out Insulation fit,
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
i
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �l� _ /6 yck A.M. _ :.M. ---- Entry,
Address: 6 4 Stc_� ,di I
Tenant: Ste:_— MST: 7'4=0-05(12_
_
Con/OwnMEC� � MEC
+dr.lk c. 1 PLM ---
Qf{ ELC: `-
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
r
Inspector: Date:
APPiIOVED —DISAPPROVED/CALL FOR REINSP. CCO
Y
f
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mach.
Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rou'ih-in Gyp. Bd. Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: _ - — -,A.M. -e;M, Entry:
Address: L` '
Tenant:_ Ste: MST: do_
BUP: _
Cori/Own:__.L_G_! L7MEC:
yz PLM:
J�� - 3 6 /� ELC:
THE FOLLOWING CORRECTIONS ARE REQUIREDELR: _
4
Aq
�� --- -
Inspector/ _x _- -__ bate:
r)O
APPROVED DISAPPROVED/CALL FOR REINSP. CF
CITY OF TIGAR . 'AUILDING INSPECTION NOTICE
Inspection Line: (j'-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sneath Framing -Mech.
Plbg.Und/Flr/Slab Plbg Top Out Insulation Ele t.
Post/Beam Struct. Mech. Rough in Gyp. Bd.
San. Sewer Gas line Appr/Sdwik Reins.
Other: & c 00C (Sex
. / `-� A.M. P.M. Entry: _ .1�
Address: ) �U _
Tendnt: Ste:__ MST�d
/�
BLIP:
Con/Own: 2 _.�Ic.�-z� MEC:— _T
` ----- -- PLM:
Y
2 36J� ELC:
TH LLOWING CORRECTIONS ARE REQUIRED: ELR:
_ - �'-'-mss---�C..� � --------------
- - - --- - ---- — __- Date:4 -X'
_APPROVED —DISAPPROVED/CALL FOR RFINSP, CF CO