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12490 SW NORTH DAKOTA ST
CITY CF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES rERMIT N. . . . . . . : MST98-0430
13125 SW Hall Blvd.,7l9eM,OR97M(503)6394171 DATE ISSUED: 12/09/98
PARCEL: 18134CB-06500
SITE ADDRESS. . . : 12490 SW NORTH D()KOTA ST
SUBDIVISION. . . . :ANTON PARK ZONING: R-7
BL..00H:. . . . . . . . . . LOM.. . . . . . . . . . . . . :027 JURISDICTION: TIG
Remarks: Interior alteration to create addition living space within existing garage area.
----------�_—�_—_—_____— - BUILDIIB ---- ------ -
REISSUE: STORIES.......: 1 FLOOR AREAS--- BASEMENT...: I sf MUIRED SET&OS---- RMIIE6----
CLASS OF WOAK.:ALT HEIGHT........: I FIRST....: 131 sf BASE.....: I sf LEFT..........: I SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 41 SECOND...- I sf FRONT.........: B PAAKINB SPACES: I
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSNENT: I sf RIGHT.........: I
OCCIIPANEY ORP.-.R3 BDRM: 1 BATH: I TOTAL : 131 if VALUE..is 6668 REAR..........t I
---- -- ---
PLUMBING --- - —
SINKS.........: 1 WATER CLOSETS.: 0 WASHING MACH..: I LAl1a1RY TRAYS.: t RAIN DIWIWIN ft: I TRAPS.........t I
LAVATORIES....: I DISHWRSFERS...: I FLOOR DRAINS..: I SEWER LINE ft: I SF AKIN MIMS: I CATCH BASING..: I
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: I WATER LINE ft: I KWH PIEVNTR: I 6AEA9E TRAPS..:
OTHER F I XTUES:
FUEL TYPES------------ FURN ( 111K ..: I BOIL/CW ( 31): I VENT FANS.....: I CLOTHES DRYERB: 0
GAS F"- )-1101K ..: I UNIT HEATERS..: I H G IDS.........: I OVER UNITS...t 3
MAX INP.: I BTU FLOOR FURNAMS: 0 VENTS.......... 1 WWrAMOVES....I 0 OAS OUTLETS...: I
------_------—-----------_-- _---------____------____-- ELECTRICAL -
—RESIDENTIAL UNIT--- --%RVICE/FEEDER--- —TEMP SW../FEEDERS— --BRANCH CIRCUITS--- --NI9CELLAEOU8— -40DIL 1NBPECTIONB—
IM 9F OR LESS: I I - 200 amp..: 0 1 - 211 amp..: I W/SVC OR FDR..: I TNAP/IPRIBATION: I PER INSPECTION: I
EA ADD'L 5119F.: 1 201 - 440 amp..: 0 201 - 401 amp..: I 1st W/O SVC/FDR: 1 9IB1/OUT LIN LT: I PER HBIM......: I
LIMITED ENERGY.: 0 411 - 601 amp..: 8 481 - 60 amp..: I EA ADDU- BR CIR: 1 SIGNAL./PANEL...: I 1N PLANT......:
MARE HM/SVC/FDR: 0 601 - 1111 amp.: 0 601+amps-IM v: I MINOR LABEL -11: I
1111+ amp/volt.: I - _-— ---------------- PLAN REVIEW 9ECTION ------- --- --
Reconnect only.: 1 )=4 AES UNITS..: SVC/FDR)z2 5 A.: ) 611 V NOMINAL: CLS AREA/9PC OCC:
---------------
—--------- ELECTRICAL - RESTRICTED ENERGY ____-------_—
A. SF RESIDENTIAL------------------ B. COMMERCIAL - -- ---- --
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO L STEREO.: FIRE AL.AIM...... INTEACONIPASIN9: OUTDOOR LNB9C LT:
BURGLN ALARM..: 0TH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIB: PROTECTIVE STGHI-:
GARAGE OPENER..: CLOCK..........s INSTRUIENTATIONi MEDICAL........t OTHNM:
HVAC...........: DATA/TELE COMM.: NURSE CULLS....: TOTAL 1 SYSTEMS: 0
Owner: -----------.--------------------------Contractor: ------------------------ -- TOTAL FEES:1 174.51
BUND SPEZIA, CAM OWNER. This permit is subject to the regulations contained in the
12490 SW NORTH DAKOTA Tigard Municipal ,'ode, State of Ore. Specialty Codes and all
TABARD OR 97723 other applicable l.vs. All work will be done in accordance
0. with approved plans. This permit will expire if work is
Phone t: Phalle t: not started within 111 days of issnance, or if the work is
N Reg C.: suspended for more than 101 days. ATTENTION: Oregon law
------------------------------------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Th •o rules are set forth in ON 952-111-010 through OAR 95P-111 !181. You may obtain copies of these rules or
direct questions to OUNC by calling 15131246-19A7.
------------- .-------.--___--- - REQUIRED INSPECTIONS
JMechanical Insp Electrical Final +�— -- --------__
Electrical Servi Mechanical Final
Electrical Rough Building Final
Framing Insp
Insulation Insp — _ _ _
Issl_ied By : Permittee Signatiarea
++++++++ ++-+--+++."4+-++ ++++++++++++i+4++++++�4+++++ ++ + ++++ + ++++
Call 63.9-4175 by 7: 0 p. mt. for an inspection needed the nex business a►y
Permit#: 1A ST'9�- D VS0
Address: _/9Vf0 S&) /1/y1E# b6WOr_
Issued by: nri — _ 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 this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 1, and either box 3A or 313:
)1. I own, reside in, or will reside in the completed structure.
rV
> JY). I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is_ _ -_ ——__
(Name) 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
A "�B- 1 will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
NBoard. 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
5 name of the contractor.
m
wI hereby certify that the above infor tion is correct and that I have:ead and do understand the Information
-i Notice to Prop ertiy,Owner s about onstruction Responsibilities on the reverse side of this form.
r 41 (.Wnatur#f pe i applicant) (Date)
6, (White copy to issuing agency permit file,
pink copy to applicant)
CITY OF TIGARD Residential 130 49 Permit ipplicatiun PlanCleelct _
13125 SIN HALL BLVD. New Construction Additions or Alterations DOW�,d p
TIGARD, OR 97223 Single Family Detached Deb to P.E.
V 603-6394171 Oft to DST
F 503-684-7297 , PennN�i it
Print or Type * c�f.d �Ay�
\ �/tZT'p't
I Incomplete or lilegible applications will not be accepted
�v
Name of Prood Narrrs
.lob rleoPe_-,-� FPW oLTt�r�l
Address �IeA�� Architect u.
lft Address
Nems — — �� 2
1P Phone
"an* -
Owner Ma ��
I fAAQ
c rsbHe Engineer M.Ifkq��•
eb 2S S'Io-47M ci�►/saat: Iron.
General Nan»
Contractor Desalbe work Nsw O AddWon O AftradonO Rspsir O
Melling Address to be done:
Prior to permit Additional Description of Work:
Issuance,a copy City/Shds Zip Phone
of all licenses / K. w�
are required If Oregon Const.Cont.Board Exp.Date PROJECT S�(O
expired In COT Lic.f VALUATION S
database
Mechanical Narrk NEW CONSTRUCTION ONLY:
Sub- A'0WiJEV__ I,151AI .Per— Sq.Ft.Horne: Sq.Ft.Garage
Contract.,, Mailing Address
Prior to permit �.,,,a W1_Tr= +"� indicate the restricted anergy installation by the electrical
Issuance,a oopy Clty/Stste M Zip Phone suboontilgiff lkn fblWwft area
of an licenses Raab Audkt/Stemo
are required N Oregon Const.Cont.Board Exp.Date EnergySystem Alanyls
expired In COT Lic.rr Installations vacuum Irrigation
database System aj ft""
Plumbing Nom.e�t / (check all that Otitor
Sub- N apply)
Contractor MnIllngrAddFOW Comer Lot YES NO Flag Lot YESENT
one check oneHas the Subdivision Plat recorded? N/A YES
Prior to permit Clty/State Z10 Phone
Issuance,a copy Solar Compliance
of all licenses are Oregon Const. t.Board Exp.Data Calculation Attached)
required If I_k.! , I hearby acknowledge that I have read this
expired In COT \ Infartnatlon given Is i correct,that 1 am the owner or au" rized
database Plumt+ing I.k.N Exp. 0 agent
of the owner,and that pians submitted are in compliance with
_ Oregon State laws.
Name Signature of
w•l "t f
�
Electrical L -�J�L `t7•
Sub_ Mailing Address arson N `70 t3
m Contractor S,pmAjtr .a di v FOR OFFICE USE ONLY:
City/Siate Zip Phone Piot g: M
J Prior to permit
issuance,a copy ✓
Setbacks: Z
of a'1 licenses are Oregon Const.Cont.Board Exp. Date r: ,
required N I..k.AA
expired In COT Engineering Approval: Planning Approval: TIF:
database Electrical Lic./ Exp.Date
I:EFREIYN.DOC(OgT)AH IAN
V C e w,�c,: L '�3 �/4/415A
CITY OF TIGARD BUILDING INSPECTION DIVISION (jjf8T
24-Hour Inspection Line: 639-4175 / Business Line: 639.4171
/Q8UP _
1Z Date Requested AM PM BLD
Location ` z.�Cl� `� 1 �JGi �4�Z� Suite _ MEC _
Contact Person Ph PLM V4
Contractor Ph _ $V
UIL Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS _
Ftg Drain SON
Crawl Drain Inspection Notes:
Slab _ SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insulation
Drywall Nailing _—
Firewall
Fire Sprinkler — �—
Fire Alarm
Susp'd Ceiling —
Roof
Misc: —
ZAS PART FAIL —
RING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains _
Final
PASS PART FAIL
MECHANICAL
Post&Beam —
Rough In
Gas Line
Smoke Dampers
Final -----
PASS PART FAIL
ELECTRICAL
Q Service
Rough In
f' UG/Slab
M Low Voltage
Fire Alarm _ - -
_ Final
CID PASS PART FAIL —� —
W0 SITE
J Backfill/Grading
Sanitary Sewer
Storm Drain [ )Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Gatch Basin [ )Please call for reinspection RE: _ ( )Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date , Inspector EXtqjj
Other —
Final
PASS PART FAIL 00 NOT REMOVE this Inspection (record from the job.sift.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST l?S &Y30
24-Hour Inspection Line: 639-4176 Business Line: 639-4171�� /
Q�'t`' SUP
Date Requested ///-4q9 AM PM i3'o U SLD
Location, `tq U -'kt) rJ 4� VAI-46, Suite MEC
Contact Perscrla je►4, GtY Ph tP'70-da�`.3� PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foi+ndation FPS
Ftg Drain SON
Crawl Drain I spection Not -K-
Slab
teSlab -+u SIT
Post&Beam -
Ext Sheath/Shear
Int Sheath/Shear
Framing !_ _
Insulation
Drywall Nailing Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _ Z
Roof
Misc:
Final —
PASS PART FAIL -- - —
PLUMBING
Post&Beam
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain Drains
Final -
PASS PART FAIL
MECHANICAL
Post&Beam
Rough In
Gas Line — -- --
Smoke Dampers
Final --
PASS ART FAIL
E,ECTRMAL, —'
Q, Service
a Rough In
UG/Slat
Low Voltage
�Ire AlarmOCT-
ID b3S PART FAIL - -- ----- - --
CW7 g
J Backfill/Grading — — —"-
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: [ ]Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARBft;� INSPECTION DIVISION �T
24-Hour Inspection i...ne_639-4 Business Line: 639-4171
BUP
Date Requested �g AM PM LD
LocationIt-�aY � Suite
Contact Person —OU— ct cyV --- Ph (.o 7 -0.'� PLM
Contra Ph SN/R
ILDIN Tenant/Owner ELC
Retsining Wall ELR
Footing Access: '
Foundation -7
Crawl
FPS
Ftg Drain SON
Drain Inspecti0 N
Slab SIT
Post&Beam
Fxt Sheath/Shear
Int Sheath/Shear — Q
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm S �� '
Susp'd Ceiling � o n
Roof
Mi c;_, �—
al��
CSS PART FAIL --
PLUMBING
Post& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain grains
Final
P. RT FAIL
ECHANIC
Fost&Peam
Rough In
Gas Line —
S ke Dampers
PAS PART FAIL
tAACTRICAL !—
Service
Rough In ^�
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain i )Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Ball Blvd
Catch Basin
LLFInal
Supply LinePlease call for reinspection RF: [ ]Unable to Inspect-no access
Aroach/Sidewalk
er Date Inspector /� Ext
S'; PART FAIL DO NOT REMOVE this Inspection record horn the Job slur.