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CITY OF TIGARD BUILDING INSPECTION DIVISION MST (o
24-Hour 24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
Date Requested AM PM _ BLD
Location C� �� �! �-�i SuiteMEC O
Contact Person Ph PLM
Contractor Ph _ SWR
BUILDING ^� Tenant/Owner ELC _
Retaining Wall ELR _
Footing Access: G t
Foundation Ai2d1�Gd,trf�/� FPS _
Ftg Drain SGN
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:
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 PART FAIL
ELECTRICAL
Service
Rough In
_ UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL _
SITE
w BtickfilliGrading
Son0ary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at Clty Hall, 13125 SW Hall Blvd
Catch Basin
Fi,e Supply Line ( ]Please call for reinspection RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspect;on record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 639-41 5 Business 'ne: 9-4171 �—
BUP
Date Requested _ a AM PM 21 BLD
Location -cl(16 5 Suite MEC
Contact Person / Ph7 PLM _
Contractor _ Ph
BUILDING_ _ Tenart/Owner ELC
L L
Retaining Wall
Footing
Access
Foundation C � ,7 /� FPS _
Ftg Drain �/ SGN
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: ----
Final
PASS PART FAIL
PLUMBING
Post&Beam --
Under Slab
Top Out --
Water ServIw a
Sanitary Sewer
Rain Drains _
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART, FAIL
.ELECTRICAL
Service
Rough In
UGISlab
Low Voltage
Fita.Alarrn
F al '
F— S PART FAIL
Backfill/Grading
LO Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection, Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE: [ ]Unable to Inspect-no access
ADA
Approach/Sidewalk Date Inspector
Other _ (W
Ext
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
PERMIT #. . . . . . . : MEC98-006/t
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 02/20/98
PARCEL: IS125DA-07100
SITE ADDRESS. . . : 09 4 C,- SW '70TH AVE
SUBDIVISION. . . . : KINGS VIEW ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :O57 j!JRISDICIION: TIG
------------------------------------------------------------------------------
CLASS OF WORK. . :ADD FLOCR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES---.--------- 0-3 HP. . . . -. 0 DOMES. TNCIN: 0
:GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP— . : 0 REPAIR UNITS: 0
FIRE DAMPERS'. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP.— . : 0 CLO DRYERS. . -. 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 0 10000 cfm : 0 GAS OUTLETS. : 6
FURN ) :=100K BTU.- 1 > 10000 cfm: 0
Remarks : TWO STORY ADDITION AND GARAGE PATH I
Owner-: FEFS ---------------
JACK D WOOLARD JR type nmol-tnt by date rerpt
946n SW 70TH PRMT $ 25. 00 JSD 02/20/98 98-303477
TTGARD OR 97223 5PC*,r s 1. 25 JSD 02/20/98 98-303477
Phone #: 293-2867
Contractor:
OWNER
$ 26. 25 TOTAL
Per; #. . : 999999
------- REDUIRED TNSPECTTnNS
This permit is issued subject to the regulations contained in the 1119chanical Insp
Tigard Municipal Code, State of Ore, Specialty Codes and all other HeAtning Unt Insp
applicable laws. All work will be done in accordance with Misc. 'Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules art
set forth in DAR 952-001-0018 through OAR 952-00I-90. You say
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9187,
Flet-mittee Signati-tv,
......................4..........................4..................... ...........
Call 639-4175 by 7-00 p. m. for inspections needed the next btisiness day
............................I...................................................
Plan Check#
CITY CSF 'TIGARD Mechanical Permit Application Recd By
1312C-SW HALL BLVD. Commercial and Residential Date Recd i
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Print Or Type Permit# 010 Q�w
_ Incomplete or illegible applications will not be accepted Called ,
Name of DevelopmenVProject Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address 4 , 5, (7 7-,',,
Bldg# Clty/State Zip 1 ) Furnace to 100,000 BTU 6.00
!� ,,/yrLo_�` 7"z z3 including duds&vents
Name(or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner t T2 . including duds&vents 7
Mailing Address 3.) Floor Furnace 6.00
`/ . C ). " ? rl including vent
CitylstateZip I Phone 4) Suspended heate ,wall heater 600
tW a -)R "J2223 or floor mounted heater
Name;or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mmling Address 6.) Boder or comp,heat purr,air Gond. 600
to 3 HP;absorb unit to 100K BUT"
C,ryistato 7, Phone T) Boiler or comp,heat pump,air Gond. 11.00
3-15 HP;absorb unit to 500K BTU"
Contractor Name— a.) Boiler or comp,heat pump,air Gond. 15.00
01"'1 Nr 15-30 HP,absorb unit.5-1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp,heat pump,air Gond. 22.50
issuance a copy 30-50 HP,absorb unit 1-1 75mil BTU"
of all licenses Csy/Stain Zip phone 10.) Boiler or comp,heat pump,air Gond. 37.50
a e required if >50 HP;absorb unit 1.75 mil BTU"
expired in COT Oregon Const.Cont Board Lic P Exp Date 11.) Air handling unit to 10,000 CFM 450
database
Architect Name 13.) Non-portable evaporate cooler 4 50
Or Mailing Address 14) Vent fan connected to a single dud 300
Engineer City/State Zip Phone 15.) Ventilation system not included in 450
appliance permit
Describe work New O Addition A Alteration O Repair O 16) Hood served i-v mechanical exhaust 450
to be done Residential Non-residential O
Addittunal Descnption of work: c A-5 17) Domestic incinerators 750
a?- N—r- 1N tvlL rot I N &0#1 t�dh i — —
E y-'.r s n tv u, Nevtf 18) Commercial or industrial type 30 00
Incinerator _
Existing use of ,>> _ 19.) Repair units 4.50
building or property ,Q .5 1 P'--)w t_ri f,.-.
20.) Nood stove 450
Proposed use of 21.) Clothes dryer.etc. A 50
building or property l _3 1 17 1-4 T r g L
22.) Other units 450
Type of fuel-oil O natural gasA LPG O electric O i 23.; Gas piping one to four outlets 2.00
R I hereby acknowledge that I have read this application,that the 24.) More than 4-per outlets(each) 50 r ,
N information given is corrert,that I am the owner or authorized agent of Le, L6
the owner,that plans submitted are in compliance with Oregon State CITY.SUBTOTAL
' laws.
J Signature of Own e g Date I 'SUBTOTAL
.1.
5%o SURCHARGE L ,
tilt ` f
.-j Con ct Pelsdn Name one PLAN REVIEW 25°,OF SUBTOTAL
TOTAL
�_Sr - k_ 0, 9-0 :s�(L. �Ibct r,, 1 _ _ ' , .
i:lmechpmt.doe (rev 9 U Minimum permit fee is$25+5%surcharge
"Resiaential A/C requires site plan showing placement of unit.
CITY OF TIGARD ELECTRICAL PEFMTT
DEVELOPMENT SERVICES PERMDATE T ISSUED: 02/20/98
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171
PARCEL- 1.S 125DA-17.171.00
SITE ADDRESS. . . ,094F,7 SW 70TH AVF
9UPDTVISION. . .. •. :KINGS VIE=W Z019ING: R-4. 5
BLOCK. . . . . . . . . . . L_O"r. . •. . . , . . . . . » . :01 7 JURISDICTION: TIU
Pro j ert Description : TWO STORY ADDITION AND WAGE PATH I
..._-RES I DENT I AL._ UN I T---- - -TEMP' SRVC/FEEDERS---- ------M T SCE:LI._ANF'OI Ic-_......
1000 SF OR 1_F=SS. . . . : 1 171 - 200 amp. '. . . . . . : 0 r-'UMP/TRRIGATTON„ . .. . : 0
F'ACH ADD' L 5O0SF. . . : 1 201 400 amp. . . . . . . : 0 STGN/OLIT LII '= LTG. . 0
I__IMITED ENERGY. . . . . : 1 401 -- 600 amp. . . . . . . : 0 !_,IGNAI_/PANEL, . . . „ » . : 0
11ANF. HM/ SVC/FDR. . : 0 61711.+amps-1000 volt,. : 0 MINOR l._ABEL... ( 1.0) . . » : 0
....-•--SERV I CE/FFEDEIR.-_.___ _____BRANCH CIRCUITS------- - - -AD1)' I._ T NSPUCT 1OIVc-
ID 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 F'ER INSPECTION. . . . . : 0
E:!O1 - 400 amp. . . . . . : 0 1st W/O qRVC OR FDR. : 0 FIER HOUR. . . . . . . . . . . : 0
401 - 600 amn. . . . . . : 0 FA ADD' L SRNCH CIRC: 0 TN PI-ANT. . . . . . . . . . . : 0
C:,O1 - 1.000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION
1.000+ amp/volt. . . . . : 0 ) =:4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. .
Reconnect Tnly. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS ARTA/SPEC OCC.
owner: _._.-_____..__..-- FEES
TACE! D WOOLARD .JR type amol-Int by date recpt
9465 SW 70TH PRMT $ 160. ..TRT) OP/211/98 78-303477
FIGARD OR 97223 SPCT 4 8. 170 JSD 02/0'0/98 9A..._3O31477
Phone #: 293-2867
Contractor:
OWNER 1,68. 00 TOTAL.
REPU I RED INSPECTIONS
m� Roi.1gh--i n Fl ect' 1 Final
.1,10ne #: Elect' 1 Service _._._..._._....._. _.
Reg tt. » 99991 9
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all tithe,
applicaf!e !aws. P11 work will t.e done in accordance with arproved plans. This permit, will expire if wor,.Iow
t started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you tohe rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- , You may obtain a cope
of these rules or direct questions to OIjNr by calling 15031246-1987.
�='r r m i t t e e i g n a t�_I r-e: � f.�:..L..,.....1.�1�lL.0[l'�-1T Z. n d By ..-_... . ----_ __ _. ... ..
------OWNER I NSTALL.AT ION ONLY---------------------_-.---__-.._
The installation is being macle on property I own which is not intended for
rale, lease, or rent.
r1WNER' S cIriNATI_IRE: 1)(IT E
INSTAL.I_ATION ONLY----------------------•-------_
I GNATURF OF !--,' J'P. F1 Fr N: DATE:
'.I CENSE NO:
4-+++++++++++++++4 4,+4.+++4 4+++4.......4++-f............4-++.4.............4-4 +++++ r + 1 +-
Call 639-4175 by 7:00 p. m. for, an inspection needed the next bl-Isiness do-
,..ti a-.a -1-j 4.++ +.++++ 1.4+++++++++++4-++++++++++++++++.(•+++4•++++++++++++++++++++++ F+
C-TY�OF TIGARD Electrical Permit Application Plan Check a
13125 SW HALL BLVD. Read By
Date Recd 7 r
TIGARD OR 97223
0 Date to P.E.
Phone (503)633-4171, x304
Print or Type Date to DST
Inspection (503) 639 4175 Permit If f~-
Fax (503) 684-7297 \ Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schede le Below:
Name of Development I NI.. s U 1 E kJ _ Number of Inspections per permit allowed
Name(or name of business)_�2A i< b j.,.c'in��A4z,4, ;P. Service included: Items Cost Sum
Address_]`SSS S L'i `)n-n4a. Residential-per unit
City/State/Zip -]'I t- r�CL O 0 2 �' '7 2 i 3 1000 sq.rt.or less 1 110.00 a ;r :i
1 Each additional 500 sq,ft.or
Commercial ❑ Residential portion thereof
Lirnited Enemy
Each Manufd Horne or Modular
Dwelling Service or Feeder $6 .00
2a. Contractor installation only;
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor Installation,alteration,or relocation
200 amps or less $60.00 -• . 2
Address _ 201 amps to 400 amps _ 0.00 2
City State^ 2111- - -- ---__ - 401 amps to 600 amps �_ $12 . 0 2
Phone No. ^� 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.0 2
�- Reconnect only $50. 2
Elec. Cont. Lice. No. Exp.Date ___ __
OR State CCB Reg. No. Exp.Date 4c.Temporary Services or Feeors
COT Business Tax or Metro No. Exp.Date___ Installation,alteration,or relocatiofr
200 amps or less $50.00 _
Signature of Supr. Elec'n 201 amps to 400 amps $75.00
- 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr, __Exp.Date -_ see"b"above.
Phone N
----- -- - 4d.Branch Circuits
New,alteration or extension per net
2b. For owner installations: a)The fee for branch circuits wit
purchase of service or
Print Owner's Name A Lk Irl 00 L 4 R , feeder lee. ---
Address r?'46 S
'�_-7 Each branch circuit $5.00
S , 4�' h)The fee for branch cirrults
City 771t, A4-A, Stated Zip r^172Z 5 without purchase of
Phone No. �k-j 1 7 7 ft p' service or feeder fee.
First branch circuit $35.00
The installation is being made on property I own which is not Farh additional branch circuit $5.00
intended for sale, lease g nt. 4e.Miscellaneous
(Service or feeder not Included)
Owner's Signature �� d Each pump or Irrigation circle $40.00 2
.41 Each sign or outline lighting $40.00 2
3. Plan Re �ew section (if required):* Signal circult(s)or a limited energy^
panel,alteration or extension $40.00
Please check appropriate item and Minor Labels(10) $100.00 enter fee in section 5B. _--
a 4 or more residential units in ore structure 4f. Each additional Inspection over
n Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00Lei _
Classified area or structure containing special occupancy Per hour $55.00 _
as described In N.E.C.Chapter 5 In Plant $55.00
I.-
*Submit 2 sets of plans wlti�application where any of the above apply. Jam. Fees: n -
.. Not required for temporary construction services. 5n.Enter total of above fees �1 $
LO 5%Surcharge(.05 X total fees) $
LLi NOTICE Subtotal $
5b.Enter 25%of line 6a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If resulted(Sec.3)
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY l�"✓ "S cD
TIME AFTER WORK IS COMMENCED. ❑ Trust Account 0
C!1 t
Total balance Due
ItU MELC96 APP ney 9198
(v
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 139-4175 Business Phone: 639-4171
Date Requested: ✓—yLT A.M. jo P.M. MST:
Location: (_ _� 7( ; //� BUR
''errant: Suite: Bldg: MEC:C79>tow
Contractor: � Phone: 2 67)"`6 7 PLM:
Owner: Phone: lL(►7 93 6 ELC:
ELR:
SIT:
BUILDING BLDG(con't) PLUMBING CAELECTRICAL SITE
Site Post/Beam Post/Beam Pot/13catn Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rau In Ceiling Water Line
Slab Framing Top Outas me Rough-In UG Sprinkler
Foundation Insulation Sewer II et Reco..nect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Maannry Ceiling Rain Drain A/C 1JG Slab
Shear/Sheath Fire Spklr/Alm Ctawl/Found Dr Ileat Pump Low Volt
Approved Approved A+•; Approved Approved
Appr/Sdwlk Not Approved Not Approved of Approve Not Approved Not Approved
FINAL FINAL FINAL, FINAL
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all for reinspection O Reinspection fee of� _required befa next inspection C3 Unable to inspect
C
Inspector: �_., _ Date � `1 Page of�2"—
r
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: A.M. P.M. MST:
Location: _ B1JP:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC:
ELR:
STT: _
BUILDING BLDG(con't) PLUMBING MkGAICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rou i-t- Ceiling Water Line
Slab Framing Top Out jd R6-8'LLin Rough-In UG Sprinkler
Foundation Insulation Sewer 41TV11 uc Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C 11G Slab
Shear/Sheath Fire Spklr/Ahn Crawl/Found Dr I lent Pump Low Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved etpprove Not Approved Not Approved
FINAL FINAL FI1 FINAL FINAL
D Call for reinspection �/7, O Reinspection fee of S_ requir d befc. ,xt inspection O Unable to inspect
inspector. _I Dater Page_'2--or
l I
CITY OF TIGARD BUILDING INSPECTION DIVISION
7.4-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: / / A.M. P.M. MST:
location: `_=� BUR
Temmt: Suite: Bldg: MEC:
Contractor: PLM:
Owmcr: _ I'honc: r� � _ ELC: _
ELR:
STT:
UILDING BLDG(con's) PLUMBING MECHANICAL ELECTRICAL SITE
Post/Beam PosU13eam Post/Dean Cover/Service Sewer/Stonn
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas line Roush-In UG Sprinkler
Foundation Insulation Sewer I lood/1)uct Reconnect Vault
Bsmt Dmnp Drywall Stonn Furnace Temp Service MISC.
Masonr Ceiling Rain Thain A/C LIG Slab
ear tihcnth Fire S ikh/Alm Crawl/Found Dr t lent 1'nmp Low Volt
ved Approved Approv;:d Approved Approved
Apnr/Sdwlk ed Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL.
J
1.'
Cl Call for reins Reinspxclion fix or$ required before next inspection 17 I fnahle to inspect
Inspector: ____._ Date: ` — � Page - —of
al
/o-7
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: a vd !! / A.M. P]vi. 5;5 M G J�
Location: �� l/� G p _s
Tenant: _ Suite: Bldg: NEC:
Contractor:_ .f1L wC Phone: PLM:
Owner: Phone: �� — ELC:
ELR:
srr:
UILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
lab j Framing Top Out Gas Line Rough-In UG Sprinkler
1Roundation Insulation Sewer Hood/Duct R-sconnect Vault
13smt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A,'C UG Slab
Shear/Sheath _Fire Spklr/Alm Crawl/Found Di Heat Pump Low Volt _
/�Jb7L12 Approved *> Approved Approved Approved Approved
Appr!Sw `—mo—mpproved Not Approved Not Approved Not Appro^cel Not Approved
FINAL FINAL. FINAL FINAL FINA:.
- t tau --T ,c_
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Inspector: Date: ���'—�7 /'� Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: � � I,/ / / __ A.M. P.M. MST: -5 �3�
Location:���� I/ 724 BUP:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/13 os Post/Beam Cover/Service Sewer/Storm
Footing Roof ndFl/Sla Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-Hr UG Sprinkler
Foundation Insulation Sewer Hood/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 Ileat Pump Low Volt
ApprovedpprovoApproved Approved Approved
Appr/Sdwlk Not Approved o pproved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
a
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Inspector. Page of
MASTER PERMIT
PERMIT #. .. .
. . . . . . . . MST95-0366
CITY OF TlGARD DATE ISSLJED: 01/19/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)839-4171 PAR['.EL_.- IS125DA--07100
i TE ('�D D f R ES G. lb 9 4 6'.5 SW 70TH 1-4 VF'
'3UBDIVISION. . . . KINGS VIEW ZONING: R-4. 5
. . . . . . . . . . . . . . . . . . . . . .. .17
.remarks: TWO STORY ADDITION AND GARAGE PATH I
--------------------------------------------------------------- BUILDING ---------------------------------------------------------------
*11 SSUE: STORIES....... : E FLOIDR AREAS---------- BASEMPir..,-, 0 !f REGUIRED SETBACYS---- REGUIRED-------------
JCLASS OF WORK.ADD HEIGHT........ : 16 FIRST,... ; 360 s'
' SPRDaE....... 552 sf LEFT.........,: 0 SMOKE DETECTRS:
TYPE OF USE—:SF FLOOR LOAD—.: 0 SECOND...: 360 sf FRONT.........t I PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS, I cINDSMENT: @ sf RIGHT........... 0
OCCUPANCY GRP.;R3 BDRM: 2 BATH: i TOTAL------: 74 sf ALUF_1: 55536 REAR..........: 0
--------------------------------------------------------------- PLUMBING --—-----------------------------------------------------------
:_I WS......... I WATER CLOSETS.: 2 WASHING MACH-: I LAUNDRY TRAYS.: 0 RAIN DRAIN ft; 0 TRAPS.......... 0
'AATORIES.... 3 DISHWASHERS...: 0 FLOOR DRAINS-: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCH BASINS.. : 0
TIJB ISHOWERS... 3 GARBAGE DISP..: 0 WATER HEATERS,: I WATER LINE ft; 0 KNLW PREYNTR: I GREASE TRAPS_; 0
OTHER FIXTURES! ?
----------------------—--—---------------------------------- MECHANICAL -------------------------------------—----------------------------
'UEL TYPES----------- FURN ( IN10K 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 2 CLOTHES DRYERS: I
GAS/ / I FURN )=INK 0 UNIT HEATERS..: 0 HOODS.........: Z OTHER UNITS—: 0
MAX 1NP.: 0 BTU FLOOR FURNACES.- 0 VENTS.........., 3 WOODSTOVES.... 0 GAS OUTLETS.... 0
--------------------------------------------------------------- ELECTRICAL ---------------------------------------------------------------
__Q;:SIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRYC/FEEDERS- ---BRANCH CIRCUITS--- ---- --AVOIL !NSEECTIGNS--
1,o2ro SF OR LESS: 0 a - 200 Polo- 0 0 - 200 amp..: A 4/SVC OR FDF,.: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
'A ADDIL 500SF.: 0 :=PI - 400 a P e.. 291 - AN ate..: @ 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 8 PER HOUP......: 0
AMITED ENERGY.: 0 401, - ('00 amm. 401 - 40 amo_ ! 0 FA PDDL BR CIR: 0 SIGNAL/PANEL,,,: 0 IN, PLANT......: 0
SANc HM/SVVFDR., @ 601 - 1000 amic.: 0 601+910IS-1000 V: 0 MINOR LABEL -it: 0
IM+ amo/volt.: 0 ---------I-------------------------- PLAN REVIEW SECTION -----------------------------------
Reconnect only.: 0 )--4 RES UNITS,.: SVC1FDR)=("2'5 A, : ) 600 V NOMINAL: CLS AREA/SPC OCCi
---------------------- ELECTRICAL - RESTRICTED ENERG,( ---------------------- - -------------------------
A.
----------
D. SF RESIDENTIAL-------------------------- B. COPKRCIP------------------------------------------------ --------------------____
AUDIO & STEREO.- VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM...., INTrPr.nM3Qr,1W,, iTTDOOR LNDSC LTi
BURGLAR ALARM-: 0TH: BOILER.........: HVAC........... : LANDSCAPEIIPRIG: PROTECTIVE GIGNL!
GARAGE OPENER..- CLOCK..........: INSTFtJMENTATION: MEDICAL........: OTHR: it
HVAC.,.......... DATA/TELE COMM.: NURSE CALLS....: TOTAL 4 SYSTEMS., 0
Dwner: -----------------------------------Contractor: ------------------------------- TOTAL FEES-1 659.85
DOUG WOOLARD OWNER
0.945 3W 70TH
*!GARD OR 97223
-hone III: 293-2A67 Phone 11.
Rey #..: 00000
',)is Dernit 's issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Soeciattv Codes and all other
covlicable laws. All wrrk will be done it acirnridaricp with aavyoyfd plans. This nervit will eyoire if work is not started within 180
days of issuance, or if work is suswridpd for more than 180 days.
-------------------——--——----------------------------- REQUIRED INSPECTIONS -------------------—----------------------------------
Foatina Inso PLM/Underfloor Gas Line Inso Water Service In Erosion Control
ca Foundation Insp Mechanical Inso I-siltation Inso ADDri5dwlk Inso
Post/Beam, qtruct Plumb Top Out Ove Board Inso Mechanical Final
Post/Beam Mechar Eravina InSD Rain drain Inso Plumb Final
Crawl Drain Fi-tolace Inso er L.M' I D
Bu' ding Fina
Pe)-r;i t;t e e i ri iiat - fssi.ted' Y .
Call for inspection 639-417"1
Residential Building Permit Ap plication
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Subdivision: �, 14L < Vrz- (,,) L tZI Lot # Office Use Only
r Pianck/Rec #
Valuation:_ tie.�' . �'
Corner Lot? Y N Permit # �15f�1,�
Flag Lott Y
Reissue of
ON � U
Map TL # /�5 j� aY n
Owner: (, I, J oC.L A it 0 Approvals Required
Address: e�, C,W UTit Planning
-I-I L ,fj_D CD-9- 5'7 2 i 3 Engineering
r
Phone: :— Other
Contractor: Items Required
Address: _ Subcontractors
Truss Details
Phone: Other
Contractor's License # _ ✓'V 141
+/ 5 f
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Englneer: _
Plumbing: _.S FO rvr Address:
Mechanical: J _
" (attach copy of current UR Contractor's License)
Phone:
JOB DESCRIPTION: LR-p r),1 c a k C2 r
n � 7 \
�Z
Applicant ignature & Phone number
Received by: c' � Date Received:
M wORDCOMDEVIRESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
i
Plumb: " / i Z�►J
Mech:
Plan Check (PLANCK)
Bldg: �`y >l G T 5•fsV 3-- 1 �� � -
Plumb:
Mech: �5 . � U ���,•
Sewer Connection (SWUSA) _
Sewer Inspection (SWIiNSP)
Parks Dev Charge (PKSUC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commerci.I TIF (TiF-C)
Industrial TtF (TIF-1)
Institutional TIF (TIF-IS) —
Office TIF ('FIF-O)
Water Quality (WQUAL) _
Water Quantity (WQUANT) _
Fire Life Safety (FLS)
~ Erosion Cntrl Permit (ERPRMT) _
J
Erosion Planck/USA (ERPLAN)
11'
Erosion Planck/COT (EROSN)
r �
1,
TOTALS:
f
Permit#:
-F -
�. Address:
ri Issued by: Date:
'rte
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 I and 2, and either box 3A or 3B:
1-1 1. 1 own, reside in, or will reside in the completed structure.
?. 1 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. #
1 will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I 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 of the
name of the contractor.
Ln
Y
I lie reby certify thaIt lie above informaIion is correct and Ihat I have read and do►understand the Information
Notice to Propert) 0%vn.rs about Consiruclio►n Responsibilities on the reverse side of this form.
100,
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
OF
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