16640 SW QUEEN MARY AVENUE-1 ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION !NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain 3over/Service FJL
Foundation Water Line Ceiling -Plumb.
Po3UB@am Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plb J.Top Out Insulation -Elect.
Post/Beam Strict. Mech. Rough-in Gyp. Bd. -Bi- 7a
San. Sewer Gas Line Appr/Sdwlk Bm
jns.
Other: p__�
Date: - Zit- f6_ A.M. i P.M. _ Entry:
Address:Tenant: Ste:
Ste:_ _ MST: _ ^
S� �y6
CSi w _ �" 7 ME MEC:
a-1't-�tliyt_GD -- PLM:
HE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
--
In pec r: = Date: 1"l1 _
__ PROVED — ISAPPROVED/CALL FOR REINS P. CFF I' U-
CO
CITY OF TBUILDING PERMIT
DEVELOPMENT SERVICES DATETT SUED • 10 BUP3F,—O�a7r
DATE ISSUED: 1O/O8/9sa
13125 SW Nall Blvd., Tigard,OR 97223 (503)6394171
PARCEL.: 2S 1 15BC.-01.000
ST FL ADDRF*SS. . . . 1664O SW QU(_-:I_._i\l HAWY r�VE
SUBDIVISION. . . . : Z.ON I IVG:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
REISSUE: FLOOR ARf''AS—_-- - ---_ F_XTERIOR WALL CONSTRUCTION--
CL_ASS OF WORK. :5e' b'K FIRST. . . . : 0 s f N: S E: W:
TYPE OF USE. . . :SF SECOND. . . : 0 s f PROTECT
TYPE OF CONST. ;SN . . . . 0 sf N: S. E. W:
OCCUPANCY GRP. :A1 TOTAL-- -- - : 0 sf ROOF CONST: FIRE RET? :
OCCUPANCY L IN D: 0 BASEMENT. : 0 s f AREA SEP. RATED:
STOR. : 0 HT: iZ] ft GARAGE. . . : 0 s f OCCU SEP. RATED:
BSMT?: ME7_Z.?: REL?I) SETBACKS —__.___.__._ PFOU I RED.
FLOOR LOAD. . . . : 0 ps f LEFT: 0 ft RGHT : 0 i"t FIR SPKI_: SMOK DET. .
DWE!_LING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR AI...RM: HNJICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VAL UE. $ : G2OO
Remarks : Tear--off two layers of roofing and install 112" CDX plywood.
Owner._ FEES
WALL. ING type amaLrnt by date recpt;
1664O SW QUEEN MARY PRMT $ 61='. 50 CJS 0(3/27/96 KING CITY
SPCT $ 3. 13 CJS 08/17/gc. ;'ING CITY
KING CITY OR 97224
Phone #:
Contractor:
DAN BURTON CONSTRUCTTnN CO
10110 SW NIMBUS AVE B- 10
T I GARD OR 9722
Phone #: 5036253272 $ 65. 63 TOTAL
Reg #. . . E�8356
RE QL.I I RED INSPECTIONS
—-- --
This permit is issued subject to the regulations contained in the Misc.. Irrspecctiorn
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspect ion
applicable )aws. All work will be done in accordance with _
approved plans. This permit will expire if work is not started
within 190 days of issuance, or if work is suspended for more
than Ifo days.
F'er,mittee Signature :
Call for inspection — 633--4:75
7r 7�
Plan Check#
CITY OF TIGARC Residential Building Permit Application Recd By
13125 SW MALL BLVD. New Construction Additions or Alterations Date Recd
TIGARD, OR S,�'223 Single Family Detached or Attached Date to P.E.
(503) 639-4171 Date to DST _
Print or Type Per rte faig!E �77
Called
Incomplete or illegible applications will not be accepted
Name of Subdivision Lot Name
Job G Architect Marling Address
I Address Siteiu
ddre s
Name
City State Zip Phone
/..I,141.
Owner i Mailing
�Address ��� Name
C. /Stat Zip Phone Engineer Marling Address
Name
Cityf�tate Zip Phone
General bl �tJ , Tr ��, •� Describe work new O addition O alteration O repair O
Contractor Mailing Address to be done:
�i i C t �r,�— Additional Derscription of Work:--rbc, r,_ 0 Z 'D..sr
Ci (State Zip Phone
Oregon Const.Cont.Boars u;c.& i« .,Date I V. T,"-' YZ;0-1—t L
Attach Copy of Projectu
Current COT Business Tax or Metro# Exo. Date Val-Lia cn
Licenses 't'`l� CM
Name NEW CONSTRUCTIO_ - ONLY:
Mechanical _ Sq.Ft. House; Sq.Ft.Gat -ge:
Sub_ i Mailing Address
Contractor Corner Lot Yes No Flag Lot Yes No
City/state Zip Phone (check one) (check one)
Restricted Audio/Stereo Burglar
Oregon Const.Cort, Board Lic.# Exp.Date Energy System Alarm
Attach Copy of
Current COT Business Tax or Metro# Exp. Date installation Garage Door HVAC
Licenses Opener Systems
Name (check all that Other.
Plumbing ( apply)
I Sub- ~Mailing Address Wi!l the electrical subcontractor wire for all Yes No
restricted energy installations?
Contractor Has the Subdivision Plat recorded? N/A Yes No
City/State Zip Phone
Oregon Const. Cont. Board Lic.# Exp.Date Reissue of MST# Solar Compliance
A'.tach Copy of I (Calculation Attached)
Current Olumhing Lic.# Exp.Date I hereby acknowledge that I have read this application,that the
Licenses information given is correct,that I am the owner or authorized agent of
COT Business Tax or Metro x Exp.Date the owner, and that plans submitted are in compliance with Oregon
State laws. }�
Name Signature o wn Agen2s L
-- 0 t� _
Electrical Contac Pe on Name Phone
Sub- Mailing Address S_
Contractor _ FOR OFFICE USE ONLY: _
CityrState Zip Phone Plat# MaciTL#:
Oregon Conpt.Cont. Board Lic.# Exp. Date
Attach Copy of Setbacks Zone: Solar:
Current Electrical Lic.# Exp Date
Licenses
iCOT Business Tax or Metro# Exp.Date Engineering Approval: Planning Approval: TIF:
I dsts"mstapp.dr•c L
Permi ;t AccountDascription Am un AmL Pd. 3A1, Due
MST. Permit (BUILD) _� JZD
Plumb. Permit (PLUMB)
Mech. Permit (IVIECH)
ELC/ELR Permit (ELPRMT)
State _T-ax (TAX) !_3 �•�
Bldg:
Plumb:
Mech:
ELC/ELR:
Plan Check
MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (S,\P1INSP)
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 PlanckJCOT (EROSN)
Fire Life Safety (FLS)
TOTALS: AL
i..^,dstslmstapp doc
Rev. 7196