15795 SW QUEEN VICTORIA PLACE mea..... p
ADDRESS:
i:\records\microfIm\ta rgets\building.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION LCL
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
4-- q/q-
Date Requested: p —� /- L A.M. P.M. MST:
15
Location:_ 7 /S �t`i�,� U(�� �.I C��a2 � BUR p
Tenant: Suite: Bldg: MEC:5��8'
Contractor: Phone: PI.M:
Owner: �t�"Yl 7'L G�- Phone: ELC:
�j� ,c.G �y ELR:
SIT:
BUILDING BLDG(con't) PLUMBING ILMECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam tam— Cover/Service Sewer/Storni
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer flood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Low Volt
Approved Approvedroved Approved Approved
Appr/Sdw?k Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
Aa
-7
CIO
O Call for C1 Reinspection fee of S_ required before nett inspection O Unable to inspect
Inspector:_ - _ Date: Page of
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
Post/Beam Struct, Mech. Rough-in Gyp. Bd. 81dg.'
San. Sewer Gas Line Appr/Sdwlk Reins.
Other- __ i
G �1
Date: /-5—5 / A.M. P.M. Entry
Address: __ f S7
Tenant: __ Ste. MST: _ U
BLIP.
Con/Own: � �� S9 9 MEC:
'I_M: __
.LC: _ �_
THE FOLLOWING CORRECTIONS ARE REQUIREL LLR:
4APPROVED
ector: __ Date:
C_ DISAPPROVED/CALL FOR REINSP. CF
CITYOF TIGARD
DEVELOPMENT SERVICES
13125 SW►gall Blvd., Tigard,OR 97223 (503)639.4171
I
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit #121 LI -b R
PO Box 23397
Tigard, OR 97223
(503) 639-4171
.. .. escriptwn
Table 3A Mochanical Code OTY PRICE AMT
Job •N J � y � �0- -0- 10.00
Address
'2'�'7�✓ u Vie' 1`_7ic r l�.Y Z_ 1) Permit Fee _
`^a ' 2) Supplemental Permit _ 3.00
« Furnace to 100,000 BTU
���Gy �m 1) incl.ducts d vents 6.00
unwco 100,000 BTU +
Owner L;U ' 2) incl.ducts d vents 7.50
.�. FFo&Furriance
3) incl.vent 6.00
M» Su&pendod rwatW-w-Z-haitair
4) or floor mounted heater 6.00
mam « -� ti. J ent not incl.in
Occupant 5) appliance permit 3.00
*» ap Repair of heating,rerig.
6) cooling,abscxption unit 6.00
.» C
BONN or comp to 3
lY a L��C �ri� -C.)'JC� 7) absorp.unit to 100,000 BTU 6.00
«� i er or camp W 3 - 1
Contractor ? 51� 8) absorp.unit to 5W.000 BTU 11,00
•i• Boiler or comp to TM-
6 J�oJ 9) absorp.unit.5 - 1 million BTU 15.00
W W•• Boiler or comp to 30- 50 HP
10) absorp.unit 1 - 1.75 million BTU 22.50
hereby acknowledge at I have road is ap icatan that Boiler or comp to 50 HP
information given is correct,that I am Cie owner ni authorized agent 11) absorp ' 1,750,000 BTU 31.50
of the owner,that plans submitted are in compliance with State r .an limy unrt two --
laws,that I am registered::pith the State Builders' Board,that the 121 10,000 CFM 4.50
number given is correct- (If eAenipt from State registration,please -Xr'T Wng
give reason below) 13) 10,000 CTM+ 7,50
Non p(xtable -
14) evaporate cooler 4.50
Vent Lan conr*cted
15) to a single duct 3.00
anti atron system not
` 16) included in appliance permit 4.50
Hood seryy -
17) mechanical exhaust 4.50
s.m work new addition a te,ation repair mastic type
to be done res' -tial non-residential Q 18) incinerator 7.50
Existing use of Commercialor in stria
building or property , �, 19) type incinerator 30.00
Other i.e,w stove,water
Proposed use of 20) heater,solar,clothes dryers,etc 4.50
building or property
21) Gas piping one to hwr outlets 2.00
Type of fuel-oil 0natural gas Q LPG Q oledric Q —"-
22) More than 4-per outlet
NOTICE
Minimum Foe$25.00 SUBTOTAL
PERMITS BECOME NULL AND VOID IF WORK OR
CONSTRUCTION AUTHORIZED IS NOT COMMENCED 5%SURCHARGE
WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 PLAN REVIEW 25%OF SUBTOTAL
DAYS AT ANY TIME AFTER WORK IS COMMENr;ED. —� -
TOTAL ,Z�'•
Special Conditions -�
Date issued by
k.+aci MT
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Ph,)ne: 639-4171
Footing Rain Dr Cover/Service FIN
Foundation Water Line Ceiling -Plumb
Post/Beam Mach. Shear/Sheathramin -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwik Reirs.
Other:
Date: _ A.M P.M. Entry: V
Address: C_L-� — ,L.1�-�-1n �. _
Tenant: Ste: MST: U
--7 BLIP:
io /Own:_1 ^J S-1. MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: _ �..- ^_. Date: 3
ROVED __DIS.'PPROVED/CALL FOR REINSP, CF CO
CITY OF TIG AR _ --^T
BUII_DiNG SPECTION f ICE
Inspection Line: 639-4175 Business Phone: L-,,2. 171
e
Rain Drain Cover/Service FINAL.Water Line Ceiling -Plumbam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fi/Slab I3Ibg. Top Out Insulation -Elect.
'lost/Beam Struct. Mech, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: ''
Date: A.M. P.M.1-00* ntry:
Address: '
Tenant: _ Ste:__ MST: Q.��
BLIP
Con/Own:-"r��"�y 3 MEC:
—
. :
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: _--. — Dat
e3
Lf
APPAOVED _DISAPPROVED/CALL FOR REINSP. CF C
crry OF TIGARD
13125 S.W. HALL BLVD. i
TIGARD, OR 97223 i
IMPORTANT PERMIT NOTICE
WILLAMETTE ELECTRIC INC
PO BOX 230547
C
TIGARD OR 97281
1
Electrical Signature
Form
Permit # . . . . : MST96. 0543 4 n/l--"
Date Issued. : 01/07/97
Parcel . . . . . . : 2S110CC-10800
Site Address: 15795 SW QUEEN VICTORIA PL l/
Subdivision. . -1 '
Block. . . . . . . . Lot. . 1
Zoning. . . . . . :
Remarks :
300 sq. ft. garage addition
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 company sign below and return this Electrical
Signature Form prior to the start of work. . 'o electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
RAY SMITH WILLAMETTE ELECTRIC INC
15795 SW QUEEN VICTORIA PL PO BOX 230547
RING CITY OR 97224 TIGARD OR 97281
Phone # : 684-9743 Phone # :
Reg # . . : 75059
r
Signature o uper is�ng _ ectrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY CF TIGARD
MA t .1Tr
DEVELOPMENTSERVICES PEyIl'T #. . . . . . . . 'ST96-0547,
13125 SW Hall Blvd.,Tigara,OR 97223 (5503)639.4171 DATE ISSUED: 01/07/97
PARCEL: 26 i. 10CC-10800
SII.E ADDRESS. . . : 15795 SW QUEEN VIC TORTA F'1_
SUBDIVISION. . . . : ZONING:
HL_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . .
Reaarks: 300 sq. f!• garage addition
--------------------------------•---------------------------------- BUILDING -----------------------------------------------------------------
REISSUE: STORIES....... : 1 FLOOR AREAS---------- BASEMENT...: 0 sf REDUIRED SETBACKS---- P,EDUIRED-----------
CLASS OF WORK.:ADD HEIGHT........: 10 FIRST....: 0 sf GARAGE.....: 300 sf LEFT..........: 0 SMOKE DETECTRS:
TYPE OF USE.—SP FLOOR LOAD....: 50 SECOND... : 0 sf FRONT.........: 10 PARKING SPACES: 0
TYPE OF CONST.:5 DWELLING UNITS: 0 rINBSMENT: 0 sf RIGHT.........: 12
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE-$: 5304 REAR..........: 16
--------------------------------------------------------------- PLUMBING ---—--------------------------------------
SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.......... 0
LAVATORIES....: 0 DISHWASHER£...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 0 GARBAGE D.ISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
-- . .-------------------------------------------------------- MECHANICNL ---------------------------------------------------------------
FUEL TYPES-------•,--- FURN ( 180K, ..: 0 BOIL/CMP l 3HP: 0 4�. T FANS.....: 0 CLOTHES DRYERS: 0
FURN ?=100K .. T UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 0 rfU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
-------------------.-------------------------------------------- ELFCTRICAL ---------------------__------------------------------- - _ --
--RFSIDCNTIAL UNIT--- ---SER'JICE/FEEDER---- --TEMP ERVC/FEEDERS ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 0 0 - 200 atop..: 0 0 - ?00 alp..: 0 W/SVC OR FOR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
FA ADD'L 500, 0 201 - 400 aep..: 0 201 - 4ba alp..: 0 1st W/O SVC/FDA: 1 SIGN/OUT LIN LT: 0 PER HOUR......: 0
_IMITED ENERGY,: 0 401 - F00 asp..: 0 401 - FQO7 aep..: 0 EA ADDL BP 1IR: 1 SIGNAL/PANEL...: Q, IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1000 alp.: 0 601+81ps-1000 v: 0 MINOR LABEL -16: 0
1000+ asp/volt.: 0 ------------------------------------- PLAN REVIEW SECT19N ----_ ---- .----------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: LLS AREA/SPC OCC:
-------.__---------------------------------------- ELECTRICAL - RESTRICTED ENERGY ----------__-_-------------------------------
A. SF RES 1DENT IAl.---- ------------- B. COMMERCIAL----- -------------------------------
------------------------------------
AUDIO & STEREO.: VACUUM SYSTEM.,: AUDIO & S"EREO.: FIRE ALARM.....: INTERCCMI/PAGING: OUTDOOR LNDSC LT-
BURGLAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL......... OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL k SYSTEMS: 0
Owner: -----------------------------------Contractor: ----------------------------- TOTAL FEES:$ 178.0E
RAY SMITH ALPINE REMODELING
15795 SW DUEEN VICTORIA PL 1535 SW 201ST AVE
KING CITY OR 97224 ALOHA OR 970%
Phone sl: 684-9743 Phone #: 780-7899
Reg C.: 7%68
This ueroit is Issued subject to the regulations contai:red in the Tigard Municipal Cnde, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This periit will expire if work is not started within 180
days of issuance, or if work is suspended for sore than 180 days.
----------------------- - ----- -- --- -- - REQUIRED INSPECTIONS ---------------------------------------------
Erosion Cantal rraoing Insp
rooting Insp Rain drain Insp
Foundation Insp Electrical Final
Electrical Servi Building Final _
rlactrical Rough
F r�rmi.ttee Sign,AtrrrC- : - - i ,s+-reel 8Y ;
C I for- i nsper..,t i.on - G39-4175
Plan Check It / <
CITY OF T;GARD Residential Building Permit Application Recd By R-b
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd /1 '�?`3V�'`y
TIGARD, OR 97223 Single Family Detached or Attached Date to P.E.12--
(503) 639-4171 Date to DST Z•
Permit# r_1 all/l
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Subdivision Lot# N me
Job ' urc�
��' 6_ /_/' y 'z Architect Mailing Address
Address Site Address
/.;-;5 ,5" ity/state Zip Phone
Name i[L 4clw 917/.4.3 9T G /,V y
Ad V Name
Owner Mailing Address L
S7 e 'C row _ Engineer Mailing Address'
City/State Zip Phane
L I rZ', �R. >7.2d'1 -y7y� City/State Zip Phone
Name
General 1jck) � _ /3L je- .kepi 6 Cescribe work new O addition O alteration repair O
I Mallin Address to be done:
Contractor g Add tcnal Description of Wo l r
I� r�\ Citylstate Zip Phone &
N I 1044 o4- �W D-
(t' Oregon Const. Cont.Board Lic.# Exp.Date
Attach copy or 7 9 d?-/a S 7 F'toject J ��4 ,
Current COT Business Tax or Metro# Exp.Date Valuation `T
Licenses .2 3i -(G/` y NEW CONSTRUCTION ONLY:
' Name
Sq.Ft. House: Sq.Ft.Garage:
Mechanical
U
Sub- Mailing Address
Contractor Corner Lot Yes, No Flag Lot Yes No
City/State Zip Phone (check one) ✓ (check one) L
Restricted Audio/Stereo Burglar
Oregon Const.Cont.Board Lic.# Exp.Date Energy System Alarm
Attach Copy of Installation Garage Door HVAC
.Current COT Business Tax or Metro# Exp.Date Opener Systems
Licenses
Name (check all that Other:
Plumbing / / apply)
rl
Mailing Addre s [re-slicted
tie electrical subcontractor wire for all Yes No
Sub
energy installations?
Contractor Has the Subdivision Plat recorded? N/A Yes No
City/State Zip Phone
Oregon Cons: Cont.Board Lic.# Exp Date Reissue of MST# Solar Compliance
Attach Copy--if (Calculation Attached)
Current Plumbing Lic.# Exp.Date I hereby acknowledge that I have read this application, that the
Licenses inform 'on given is correct, that-4m the owner or authorized agent of
COT Business Tax or Metro# Exp.Date the qifin4r, and that plans subitte ire in cont t ce with Oregon
Sta la s.
Name S a re of Owner/Ag Date
Electrical �iL LA.+�e r'� �G G % Coma erson Nm
ae P ne
Sub- Mailing Address
Contractor v, aUx �3 US�!7 FokbFFICE USE ONLY:
City`ISt to Zip Phone Plat# Map/TL#:
L " 2.);Iel/ "7 J6 3�
nrego, Const.Cont.Board Lic.# Exp.Date
Attach Copy of 7S D,S,c Setbacks Zone: Solar:
Current Ele thcal Lic.# Exp.Date
Licenses 3V-1 f-3 C
CVusigeATax r Metro# Exp.Date Engineering Approval: Planning Approval: TIF:
jsts\rnstapp.doc ��!!
Permit# Accgunt Description Amount Amt. Pd. Bal. Due
r. y3 (BUILD) ��," �3°`la
1�IsfyG-os MST. Permit aro
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT) 0
State Tax (TAX)
Bldg:
Plumb:
Mech:
ELC/ELR: �•�� j
Plan Check .7�
MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: C-Vc�i�' ` (MECPLN)
P
CDC Review ��c (LANDUS) G, �u p, •'' /
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS: / 7�,0(o (p 0,
i:Wsts\rn$13pp.doc
Rev.V98