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is\records\microflm targets\building.doc
July 1, 1996
RECL-IVE j
Mr. David Scott , ".�.
Building; Official JIJL C1 )
1712.5 ,1 Hall. Blvd.
Tigard , OR 9722'
COMMUNITY UEVELUNMtIVI
Dear Mr. Scott,
had a financial set-bacic after taking out oar lermit, number
BUP711 t- 94', on June 6, 199,. ,`le would like to pull our permit
rvv this tLie but be allowed to resubmit at a later date .
';le intend to extend the front wa.11c roof line but it Isn't
financially ,possible for us to do it at this time. Thank ,you
for your time in this matter.
Ale�- A 4-A
James T'. and Cynthia L• 9��r'
101 ;3 S`„ Riverwood Lane
Tigard$ OR 97224
i)honc 6,10-2518
VV
�.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 07223.8199 (503)834-4171
City of Tr3ard Residential Building Permit A '
Application '
�
13125 SW Nall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 116 rl 5 SYJ kW tW (DOD L ANC
Lotif c I Office Use Only
Subdivision:
Valuation:
o PlanckJRec #
—'
Corner Lot? Y N Permit #
Flag Lot? Y ` N Reissue of
Map & TL#
Owner: Ap rp ovais Re :aired
Address: Aq3,3_ q3,351,x? A\\jePVjt-xA0 U1 Ne Planning 1 �' _
Engineering
Phone: c I(IN �,a_ Other
Contractor: _ Items Required
Address: ' Subcontractcr
Truss Details
c1hone: Other
Contractor's License #
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors: Arch iiect/Engineer: OL500 G2WP AOC1II<<C75
Plumbing: Address:
Mechanical:
(attach copy of current OR Contractors License)
Phone:
JOB DESCRIPTION: t I�Nn L"x`_t►�,�711'yafie
D 311
Appi ,leant Signr ture � Phone n,Li )er
Received by' Date Received: _ A.
Permit# Account Description Amount Amt. Pd. Sal. Due
au .0 Bldg. Permit (BUILD) _
Plumb. Purmit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) �—
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
_ Sewer Connection (SWUSA) —
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-P`
Mass Transit TIF (TIF-MT)
Commercial TIF (TI--C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL) _-_--
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) —
TOTALS:
CITY OF TIGARD
BUILDING DIVISION
RESIDENTIAL PLANS SUBMITTAL
APPLICANT NAME: Jnme`> '4 C'Vo,01I11 Alockt(70 AN CHECK #
ADDRESS: ��3 P wek7wcr�) L rJ PHONE # (odd '�?_ 3/8
DATE RECEIVED: _ RECEIVED BY:
CHECKLIST (All items must be in packet before plan will be reviewed)
YES NO N/A
1 . ( ] [ ] [ J 3 FULL SETS OF BUILDING PLANS (No red line revisions
or tape-ons).
2. [ ] [ ] [ J 5 SITE PLANS(including tax lot and tax map number, easements,
erosion control provisions, floor elevation of garage and main
floor, set backs, drive-way location, north arrow, scale, location
and termination of rain drains, all property corner elevations, and
contours if over 151% grade).
3, [ J [ ] [ J 6UILDING PLANS SHALL REFLECT TONOGRAPHY OF LOT
(if house is designed for a flat lot anc the lot is not flat, revised
drawings are required. No red lines accepted).
4. [ ] [ ] f ] REVISION TO PLANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (detailed sections may be
different from the originals as a result of your charges. These
portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
5_ [ ] [ ] [ ] FLOOR PLAN(S)
6. [ 1 [ l [ l FLOOR FRANIING
. [ ] [ ] [ J TRUSS JOISTS (engineering, elails and layouts)
g. [ ) [ ] [ ] ROOF FRANIING PLAN (all hips and valley supports indicated
and detailed).
— OVER —
YES NO N/A
9. [ ] ( J [ ] ROOF TRUSSES (engineering, detains and layouts)
10. [ J ( ] [ J COMPLETE CROSS SECTION(S)
11 . L ] [ ] ( ] ALL 4 ELEVATIONS ARE SHOWN - s ELEVATIONS FOR
ADDITIONS AND REMODELS
12. ( ] [ J [ ] BASEMENT WALL, FOL,NDATION AND RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [ 1 ( ] [ ) WALL BRACING (structure must meet table R-302.10, revised
alternate method 93-7, or a lateral design shall be provided)
14. ( ] [ ] [ ] ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. No attachments are
allowed.
15. [ ] [ ] ( ] BEANt CALCULATIONS (all beams over 10 ft. in length or any
beam that supports a point load).
16. [ ] ( J [ ] ENERGY CODE PATH IDENTIFIED
DO NOT MAKE CORRECTIONS IN RED
NOTE: A tree removal permit shall be required for cutting of all trees that are 6" or
larger in diameter at 4 feet above grade. Permit application forms are
available from the Planning Division. Two copies of a site plan showing the
location of the trees and proposed building are required with the application.
if/submit.lst
Permit#:
Address: .. .)q� 5._3 > �:✓P,�'t�a c7f �..
Issued by: Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS' 701.055(=1), 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 he issued. This statement is required
for residential building electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt front registration under ORS 701.010(7),
need not submit this statement. This statement kill befitled with the permit.
Fill in the appropriate I yanks and initial boxes i acid 2, and either box 3A or 3B:
1. 1 own, reside in,or will reside in the completed structure.
2. 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 ________
l—� (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
3B. 1 will be my own general contractor.
If I hire subcontractors, i will hire only subcontractors registered with the Construction Contractors
Board. 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,,-)f the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
A _ _ �5
(Signature of pe it applicant) (Date)
(White cope to issuing agenc.v p. rrnit file,
pink copy to applicant)
t Y or C''C.uARD PF-'.CT I P i CIF f't't YMV 14 1- ri
-!��TTMJ NO. 05- k'J,636 I
CHECK AM01,1W 2. 00
NAME Al2RIGON1, JAMFEi 111. CA':;H AMOONT (A. 00
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