9075 SW PINEBROOK STREET-1 ADDRESS:
2E
uJ i rod r�
i:\records\microflm\targets\building.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171 r
Date Requested: I l I / A.M. _ P.M. — MST: _
Location: BUP:
Tenant: Suite: Bldg: MEC:
Contractor:! Phone: (..� _�j _ PLM:
Owner: Phone: ELC:
LC ) —L,_1, "� ELR:
r
9=mmmm SIT'.
BUILDLYC (coni) P IIY� MECHANICAL �,Ty ECTRIC SITE
Site os Scam Post/Acam Pogtll"n Coverftivi" Sewer/Storm
Footing Roof UndFl/Slab Rcugh-In Ceiling Water Line
Slab Framing Top Out (Taal Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hooi/Duct Reconnect Vault
lismt Damp Drywall Storni Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C ?TG Slab
Shear/Sheath Fire Spklr/Alm Crawl ' and Dr Heat i,unp l.ow Volt
ApptoveCovc Approved
Appr/Sdwlk Not%proved of ApProved Not Apprmt-1 I�ot roved Not Approved
Ia IN FINAL-' FINAL FINA ` FINAL
r
Cl Call for ems n Reinspection fee of r uired before ext inspection C3 Unable to inspect
Inspector: Date: J Page—!__of
I Y CITY OF TIGARD BUILDING INSPECTION NOTICE /
Inspecdon Line: 639.4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service AFI
Foundation Water Line Ceiling I
Post/Beam Mach. Shear/Sheath Framing ec
Plbg.UnJ/Flr/Slab Plbg.Top Out insulation Ele
Post/Beam Struct. Mach. Rough-in Gyp. Bd.
Scn. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: _ A.M. _P.M._, Entry: —_—
Address: -
Tenant: Ste: _ MST: �dd/
BLIP:
Con/Own:_ t � — PLC
ELC: -a
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector. f_ Date:
,APPROVEDAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINA
Foundation Water Line Ceiling -Plum
Post/Beam Mach, Shear/Sheath Framing -Mach.
Plbg.Und/r-Ir/Slab CPttFg._T2p()ui-' Insulation Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Hein
Other: _�
Date: —_ A.M. P.M.
Address: — R..
Tenant Ste:_ MST:
BUR ,
Con/Own: _ _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
fns -tor: _ _ Date:
APPROVED __DISAPPROVED/CALL FOR REINSP. CF r Z�
C
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/Bear i Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-In Uyp.BV -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: _ A.MP.M. Entry—
Address: ._ `I !���-C
Tenant:_ s_ __. Ste: MST—
BLIP:
Con/Own: - $�� � _ MEC:_
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: Dater
_� PROVED DISAPPnOVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639.4171
Footing Rain nra;n Cover/Service FINAL-
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach, Shear/Sheath Framing -Mach.
Plbg,Und/Fir/Slab Plbg.Top Out sura gll'7 -Elect.
Post/Beam Struct. I`1ech. Rough-in Gyp. Bd -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: j I
Date: A . P.M. En ry:
Adoress:
Tenant: _ Ste:___ MST:
C BUP:
Con/Own: G r. j MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
Ins ector: ___ Date:.
_. PROVED ___DISAPPROVED/CALL FOR HEINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOT!CE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain over/Service FINAL:
Foundation Water Line -Plumb.
Post/Seam Mech. Shear/Sheath amin
Plbg,Und/Flr/Slab Plb . T Insulation
Post/beam Struct. Mech. Rough-in Gyp. Bd. Bldg.
San. Sewer ine Appr/Sdwlk
Other:
Date: A.M. _,P.M. Entry:
Address:
Tenant:- ------ Ste:Ste: MST: Z!n
BLIP:
Con/Own: MEC:
PLM:
ELC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
7
Inspector _ Date:
_ PPROVED _DISAPPROVED/CALL FOR REINSP. CF CO
CITYOF TIGARD BUILDING INS"ECTION NOTICE I
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 -Mech.
Plbg.Und/Flr/Slab Ibg. Top Out, Insulation -Elect.
Post'Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: -� �� A.M. M._' Entry,;_
Address: L' 7�� _J!"�'--L�• C
Tenant: ---–�_�.� — ---- Ste: — MST: -0-0-0
BUP:
Con/Own: _ -- _ — _ MEC:
PLM: —
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Date:
7_N�PFIOVED _DISAPPROVED/CALL FOR REINSP. CF C
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspectwn 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.1bp Out Insulation -Elect.
Post/Beam Struct. ech. Ro gR- Gyp. Bd. -Bldg.
San. Sewer as Line Appr/Sdwlk Rains.
Other:
Date: � ±�— A.M�j-7—P.M. Entry-
Address: 901.!T
Tenant: Ste: MST:
Con/Own: /`/ BIJP:_ 1 a �i -� 9 MEC: _
PLM:
ELC:
THE FOLLOWING CORRECTIONS AT REQUIRED: ELR: _
rfl 1
Inspector _ Date: _
`APPROVEDDISAPPROVED/CALL FOR REINSP. CF O
CITE' OF TIGARD
ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT 4:
EL._C:97--0075
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 02/07/97
PARCEL: 261 1 1 AC---OO I OO
ITE" ADDRESS. . .: 0901,'..,;,':., `-:)W P T NEPROOK ST
SUPDIVISTOIV. . „ . : 1-11NF RROO14 TERRACE ZONING:R- 14. `°,
8L_OCK.. . . . , . . . . . , I.._OT. . . . . . . . . . . . . :4,',
Pr-oject De ser i pt i.on : I NSTL 2 BRANCH CIRCUITS
_.__RESIDENTIAL_ UNIT----- _ --TEMP' S RV C/FF=EDERS------- - --M T SCFLLANEOUS-•-.._--
1000 SF OR LE:SS. . , , 17r - �'0 aml3• . . , » " PUMP/IRRTGATTnN. . . , : 0
EACH ADD' L. 5O09F. . . : 0 2"01. - 400 a.m p. . . . . . . : 0 SIGN/OUT LINE LT'G. . : 0
1...I M I TE D E.Nr RGY. . . . , : 10 401 _- 600 amp. , . . . . . : 0 S I GNAT.../171A11E:L. . . . . . . .. 0
MANF. HM/ SVC/FDR. . : 0 601-+amps-1000 volts. : 0 MINOR LAPEL.. ( 1.0) . . . : 0
ICE/FEEDER--------. ._--•-.-BRANCl-{ ....._..ADD1I . INSPECT IONS -
0 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
1. - 40171 amp. . . . . . : 0 t st W/O Spjr np r=Dr?. : I. r'F.=f? I{Ol..lp. . . . . . . . . . . .. 0
401 - GOO amp. . . . . . : 0 EA ADD' L PRNCH CIRC: I III Pt-ALIT. . . . . . . . . . . : 0
(i "11. - 1.000 amp. . . . . : 0 _._.. ....__.....1-'I. All Rr)1EW SEr-;..i I ON....-.....
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 800 VOLT NOMINAL . . :
Recnnnect on 1.y. , . .. . : 0 SVC/FDR ) 22`i AMPS. . : CLfaSS AREA/SPEC OCC.
Owner-. ____.__.__-____.______ __..______.______..__ ___...___._______..____ FEES
WAYNE. KT'TTI._E.SOI\I 1;ype date r'ec-lit
9075 SW PINEPROOK ST PRMT $ '+0. 00 TAT 02/07/97 97-29OOBE3
5PC1 $ x:'. 00 TAT 0.:'/07/':37 97--29OO8B
T I GARD OR 97223
Phone #k:
Contractor: ----_...-_____.__._---.___-________...___._._.______...._._.___..__.___.___.
WESTS I DE ELECTRIC 00 T 0 T A L
7518 SW MACADAM AVE-
_.-. REQUIRED INSPECTIONS
__..._-._.
PORTI__AND OR 9721.9 Ceiling Cover Undergr-ol_rnd Cove
Phone #: 503-245-3385 Wall. Cover Elect' ] Service
Re!]
This perait is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and 311 other r='vI-m i t1 P�p rign- te
f�f
applicable laws. All work will be dare in accordance with /
apprcved plans. This permit will expire if work is not started /�
within 180 days of issuance, or if world is suspended for sore
than 188 days. Ess i-r e d H y
_._.__._...........____......__.._._..._._..._...__. ... __. OWNER TNSTAI_.L.ATTON ONI__Y•--_ __._____._._._-_._. ._._._..._...._._._._..,
The installation is being made on pr--oper-ty T. own which is not intend, for
lease, o•r- r,ent.
OWNER' S SIGNATURE- DATE:
INSTALL.ATTON ONLY .._ .. ____...._.___._...._... __. .___._..._....._._.__...........
9IGNA,rURE OF SUPR. E'I._EC' N: _ - DATE
I._T r E N S F N O:
Call for- inspection - G394175
i
Communifv Development ELECTRICAL PERMIT APPLICA 71ON
13125 SW Hall Blvd. l t l
Tigard, OR 97223 Permit # � -L � � � (>> / >
Date Issued
Phone (503) 639-4171
CITY OF TIG4RD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address. 4. Complete Fee Schedule Below:
Name of Development ( Number of Inspections per permit allowed
Address °lVr //L2 XI U(7 ) Service included. Items Cost(ea) Sum
City/State/Zip /LlCri� 4a. Residential -per unit
1000 sq ft nrless $11000 _ ^
Name (or name of business) %Ci //JCY7 o /T Each additional Soo so fl or
portion thereof $25.00
Commercial ❑ Residential Limited Energy $25.00
Each Manure!Home or Modular
0"liing Service or Feeder $88.00 2
2a. Contractor installation only:
4b. Services orFeeders
J/ Installation.alteration,or relocation
Electrical Contractor F1:�1 1z % _ 200 amps or less $80.00 2
Address <i<C< �lir7 201 amps to 400 amps $8000 2
$12000 2
City 6)/- /r State 7 Zip 401 amps to 800 amps $180.00 2
801 amps l0 1000 amps
Phone No. ` Over 1000 amps or volts $340.00 r 2
Job NO. Q -QL) Reconnect only $50.00 _ 2
contractor's license NO. Z6, - ,, 4c. Temporary Services or Feeders
Contractor's Board Reg. No. ' t Installation,alteration,or relocation
Signature of Supr. Elec'n 200 amps or less
201 amps to 400 amps 5.00
License No. /S ( � Phone No. $7
� 401 amps l0 800 amps E75 00 z
Over 800 amps to 1000 volts $10000 --
2b. For owner installations: see"b"rbova
4d. Branch Circuits
Print Owner's Name- -__ Now,alteration or extension per pone
Address a)The fee for branch circuits with a
Cit State Zippurchase of service or feeder fee.
City. -- - Each branch circuit $5.00 _
Phone No. b)The fee for branch clrcults without
The installation is being made on property I own which is purchase of service or feeder fee. z
First
not intended for sale, lease or rent. a
r $35.00
Eaccbranch
additional branch circuli = $5.00
Owner's Signature _ 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or Irrigation circle $40.00
Each sign sign or outline lighting $40.00
Signal clrcult(s)or a limited energy
Please check appropriate Item and enter fee in section 58. panel,alteration or e.tenslon $40.00 _
_4 or more residential units in one structure Minor Labels(10) $100.00
_Service and feeder 225 amps or more
4f. Each additional inspection over
System over 600 volts nominel
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E C Chapter 5 Per hour 55 n0
lion $
Per hour $5500
In Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $
9%Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%r'line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review If reauired (Sec.3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wwA.nmArNelec [--ff Trust Account # $
1".NM
Balance Due
$
CITY OF TIGARD r 7CHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 D R M I TS':4. . . . . . . : MEC 9 7- 10
DATE T�,�l.1FD: Oc'/05/97
PARCEL- ''.S 1 1 1.AC--0Vi 100
ITE* ADDRESS. . . : 0907,'--1 SW P T NE.ROUP ST
SUBDIVISI019. . . . : PTNEBROOI'\ TERRACE 7f71N1'TIUG. R- 5
Bl-OCK. . .. . . . . . . . . 1-01.. . . . . . . . . . . . .. ;42
0-ASS OF WORE(. . :ADD FLOOR FURNI. . , . : 0 EVAP COOLERS: 0
TYPE OF USE. . - . :SF UNIT HF'ATER . . : 0 VENT FANS. . . : 0
OCCUPANCY (:SRF'. . :R3 VENTS W/O APDL.: 0 VFNT SYS'TE'MS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ 1"YPF_S- --___....___... _.__ 03 HP. : 0 DOMES. T.I\IC T ISI: 0
: /GAS/ / / 3-15 HF'. . . . : 0 COMML. I NC I N: 0
MAX I NPUT: 0 BTU 15--3127) HP. . . .. : 0 REI'_''A T R UNITS: 0
FIRE; DAMPERS'). . : 30-50 HP.. . . . : 0 WOODSTOVFS. . : 0
GAS F'Rr `;SURE. . . : 5F)I + HP. . . . : 1 CLO DRYERS— : 0
NO. OF UNITCi---- ------ AIR HANDLING UNITS OTHER UNITS. : 0
FI_IRN ( 100K BTU- 0 (- 1,0000 c.f m : 0 GAS OUTI...E"1-1 ,
FURN ) =1O0K BTU: 1 > 10007 r_fm : 0
Remar,l{s : TNSTL. FURNANCE DUCTS R VENTS, GAS PI1" ING, O11T L.ET'3 & A/C ((1/C; UNIT'S CANN
OT
BE PI-ACED OUTSIDE_ SETBACKS
Owner.: - _._._______._..__...____.._.._...------_...____.___._...__.._.______..._...._..__._____ .-- FEES
WAYNE KI'TTI_FSON type amai_int by date recpt
9075 SW PTNEBROOK PRMT 4 47. 00 R 0=/05/97 97--289956
PI_ CK $ 11. 79 B 02/O5/9'7 97--28995F
TTGARD OR 97L24 SPCT T 2. 35 B 02/05/97 97--289956
Phone #:
Contractor:
COI-I_JMB I A HFAT T WC
PO BOX 230397
TIGARD OR 97x_''81
Phone #,, (-,P4---':?'704 61- 10 'TOTAL
Reg #. . : 000 763
_._..____... REOU I RED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Post/Beam Insp
applicable laws. All work will be done in accordance with Mechanical Insp
approved plans. This permit will expire if work is not started Mi sc, Inspection
within 180 days of issuance, or if work is suspended for mare Final Inspection
than 180 days.
' r•m i.t t e E? S i Ila t 1_t
y
Cal. 1. fc)r inspection 639--4175
Plan ChecK p
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 n I Date to P E
(503) 639-4171, x304 1161 �Q(�1t+- ���1�1�`'Y�' I �1�{ ti�-
� Date to DSTPrint or Type Uh ( Permits 1�1��z3
Incorn lete or ille ible a lications �I�It o8e ed Called _
P 9 PP
Name o evelopmentiPrciect Description
w o, r " Table to Mechaniwi Code CITY PRICE AMT
Job 'treatAaarea - sunea A) Prarmlt Fee -0- -0- 10.00
Address `7 �)
Bldgs )State p c _ B) Supplemental Permit 3.00
Nam for name of business) - 1 i Furnace to 100.000 BTU 6.00
Owner `_ YL� l� — C, ncl.ducts&vents
Mailing Address 2.) =urnace 100,000 BTU+ 750
r(j
.ncl.ducts&vents 7,
City Slate Zip Phone 3) Floor Furnace 600
incl.vent
Name(or name of business) 4.) Suspended heater,wall heater 600
_ or floor mounted heater
Occupant Mailing Address 5.) Vent not incl In 3.00
appliance permit
city/state Zip Phone 6.) Boder or comp,heat pump,air Gond. 6.00
to 3 HP;absorp unit to t00K BTU
far a O. 7.) Boller or comp,heat pump,air Gond. 1 1.00
YY_ 3-15 HP,absorp unit to 500K BTU
Contractor MIlin9 Add � 8) Boder or comp,heat pump,air Gond. 15.00
�� 15-30 HP,absorp unit.5-1 and BTU
(Prior to --g"ay,stale .� r Ip Phone ,7 II'� 9) Boder or comp,heat pump,air Gond. 22.50
issuance a copy C C C-n��•, p '� U-r,�!( Y 30-50 HP absorp unit 1-1 75 and BTU
of all licenses are o sl o� 1Jc a Exp.Clete 10.) Boder or comp,heat pumplai�nd.l 37.50 3�`,lr
required if -1 .� >50 HP;absorp unit 1 75 and BTU
expired in C.O.T Cot U. Ma Tax Metro Exp Date 11.) Air handling unit to 4 50
data base) C 1_0.000 CFM
Architect Name 12.) Ai haniJling unit 7 50
10.000 CTM+
or Mailing Andress 13.) Non portable 4.50
evaporate cooler
Engineer CGty'state Zip Phone 14) Vent fan connected 3.00
_ to a single duct _
Describe work New O Addition 0 Alteration O Repair O 15) Ventilation system riot 450
to be done Residential O Non-residential O included In appliance permit
Additional Description of work. 167Hood served by mechanical exhaust 4.50
_ 17) Domestic Incinerators 7.50
Existinn use of 18.) Commercial or Industrialtype 30.00
huiklilig of property_ incinerator
1units _ 4 50
Proposed use of 20)0) Wood
Woodstove 450
building or property
21) Clothes dryer,etc. 4 50
Type of fuel-oil O natural gas O LPG O electric 0 22) Other units 50
I hereby acknowledge that I hav read this application,that the 23) Gas piping one to four outlets 200 �1
information given is correct.that I am the owner or authorized agent cf r
the owner.that plans submitted arg rn complian..: 6th Oregon State 24) More than 4-per outlet (each) 50
laws. �� _ --cl
lure Of lAgenV Date QTY.sUBTOTAL )
_ � 7
'SUB TOTALU�
_ 4
Contact Person Name _ Phone 5%SURCHARGE
a3
PLAN REVIEW 25%OF SUBTOTAL I I ./.&
TOTAL I )-1
I klst\mechpmt doc (rev 7/96) 'Minimum permit fee Is S25+51-1.surcharge
CITY OF TIGARD BUILDING INSPECTION NO710E
Inspection Line: 639-4175 Business Phnne 639-4171
Footing Rain Diain Cover/Service F L:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framin -Mach.
PIbg.Und/Fir/Slab Plbg.Top Out nsulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: —
Date: -7- 3 _ 9 �' A.M. P.M. p Entry:
Address: 90 -75 5 cJ !4—At-e
Tenant: Ste:____
BLIP:
Con/Own:.— MEC:G _
0 1 14 q7 a5 PLM: -
ELC: _—
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
7-0 86
_V,g7rTr,�rz
Inspector: --.—_- _ Date: rb
ROVED _DISAPPRO IED/CALL FOR REINSP. CF CO
APPLICATION STREF f IMPROVEMENT/EXCAVATION COPY TO:
® (WHITE)-FILE
ORDINANCE NO. 74-14 (YELLOW)-INSP.
-OTHER
(INSTRUCTIONS ON SEPARATE SHEET) (BLIUE))•APPL CANTNCY bldy
L11
APPROVED & APPLICATION NO.: �_ � i _----
NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE AMT.: S 18.00
PENDING FEE. PMT. ❑ CITY HALL RECEIPT NO.: Jl ,
PENDING SECURITY Cl PUBLIC WORKS DEPARTMENT BY_= _'� DATE_ _ _ L _
PENDING AGEN :Y "OK" ❑ Applicc`ion and Progress Record MAINTENANCE BOND it__-----
FOR STREET IMPROVEMENT/EXCAVATION AS RE0u�i7Eu ,
PENDING INFORMATION ANNUAL O
PENDING VARIANCE ,7 EXPIRATION DATE: --
PERMIT NO. 1: _-_ DATE ISSUED: - _ L ' '__-- BY:
(1 ) APPLICATION IS HEREBY MADE 1'0 EXCAVATE FOR AND ItISTA;i L. MiUDIFY AN EXISTING DR.IVEMAY „
AS DESCRIBED HEREIN, IN FUL!_ ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT F2c.at:dalr 6Ullu is, Lllc_ 46iJ oi4 juUi PlaL:u Purtland, OR 97221 - 292-5261_)
NAME AOOR f CITY HONE
CONTRACTOR - (aat4l ---- — --
NAfI— AO CITY SHONE
PLANS BY __._Per City Starlda:ds & Si)eCifiotiols _
N ATNF AOO�� CITY PHON
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
OOLLAnS
(2) EXCAVATION DATA: - FOR 004 VFICE,06: 00 a 18.00 CMIN.`
STREET _ DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CU'r MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM A QUANTITY
T'RFET
S
FNEO
Plnebrook S — R TIO -
::z. ,ti'...I.ci ')1�'t-� .. R TION
Q
U —
ESTIMATED STREET OPENING DATE: FS
T —
ESTIMATED STREET CLOSING DATE: . L I E
-- _--- 450.170 STI4ECT
(3) SECURITY NO. _ _ SECURITY AMT.: E CLOSED_
SURETY CO.: � -�- - _-� __ FINAL,
Q&S&T4 4*n CHECK �I CASM O BOND INSPEC.1. _
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS !CONDITIONS.
FEATURES; EXCAVATION LOCATION AND EXTENT.
:see attached - ---
i I I SITE: #&! SW Pinebroo SfL 1
work area
�� (` _; XXX � _ _ .,�� -- •�` � _---
URB
S.W. PiNf,8ROClK STREF"P7 "
-�_ -- --
1 I I !
(S) NOTE. THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AtsrlFES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE y�WHICH MAY RESULT FROM APPLICANTS ACTIONS.
���« • /
�� APPLICANTS.,,:..'TURE: _� DATE
Sr:ciai Conditions/Provisions:
1 . All work shall conform to City of Tigard, Oregon, Standares and Specifications.
Note the attached Drawings and Details.
2. Notify City Inspector Letha Thomas (tt639-4171) 24 hours before starting any work. `
3. Access-to and egress-from parcels of land adjacent to the work area shall be
maintained at all times. Pedestrian safety shall be provided for by the contractor
at all times.
4. Removal/replacement work and damage repair work shall be promptly initiated and
completed to the City's satisfaction. No work shall be considered complete until
it is accepted by the City. The City reserves the right to cause testing anu
certification of work or repairs to be performed, to the City's satisfaction, at
permittee's expense.
5. Erosion control shall be provided for by the contractor.
6. ORS 757.541-5-171 applies (pre-notification for location of underground facilities,
etc.).
7. It is the sole responsibility of the permit holder to provide for proper right-of-entry
(and/or easements) prior to stat'ng work. Proof of right-of-entry (and/or properly
executed easements) shall be providea o the City. The City shall in no way be
construed to be liable for the permit holders failure to obtain or provide for proof
of rght-of-entry (or easements).
8. All easements deemed necessary by the City, to facilitate operation, maintenance
and access to new public facili-�ies or to enable public Usage of sidewalks, etc.,
shall be properly prepared, sxecuted and provided to the City prior to City release
of any work assurance funds and prior to City closure of the cr ciect permit.
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Utility relocations, modifications or repairs, which may be n-3--sssary, shall be
performed in a timely manner at the pe'rmittee's expense.
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�ELISTiNG COME3INATION - PLACE AOHESh'E ALCNG
CURB AND GUTTER JOIN7 IMMEDIATE PRIOR TO
POURING NEW CCNCRETE
SEt NOTE 4
CURB AND GUTTER
CCNSRUCT 1/7' TO
3/4" RADIUS UP
_ — CONSTRUCT C`•,•�'NAY APRON
MIN. S' SAWCUT M40
VERTCAL BREAK
o-
9 •. ,
SIM' .. o, ,
PLACE ADHE-,—E ALONG
EXISING JOINT IMMEC':JELY PRIOR TO
PAVEMENT SECTON PCURING NEN CONCREit
STANDARD CURB
NOTES
1 . SA',VCUT THRCUCH G=,,-.R PLAiEt SHALL EE MADE A-S CLOSE
TO CURB FACE AS POSSIELE
2 CCti1PLE!E CURB ANO GUT-R SHALL NOT GE REti .J UNLESS
�IR�C ED EY THE ENGINE_R.
3, ',vHEN Si�alG' CURES ,-iFE REMOVED, A MINIMUM C•-• 2 F==!
CF PAV=!.IEYT F DM i rE FACE CF CURB SHOULD E: REMOVED
4. 'MI=EN E`fi1iE GUT ER PLAr- IS REMOVED i r!E E<IS,'
PAVEMENT ca ALL EE C'jT SACK AND A 6' MCNCL`T'r',': CU'NCRE--
EENCH SH.AL' SE CCNSirtUCTED WITH THE NEN GUT -.R TO PROVIDE
SUFPORT UNCER PAVEME`7. (SE= VALL-"Y GU! E.R CE'aILS).
CURL KNOCKOUT
FOR DRI`V'EWAYS
Awr.'I. APPgC'•`= 5Y CP.AI*4 3y
PWA :11 CAB
CITY OF Zl(GARD o�. FLE
OREGON X.T.S. -9-�� •-s-r•�.��c
VAX, 10'-0. MIN,
EXDRIVEWAY
VARIES 'MOTH VARIES
(SEE TABLES) MATCH GRAD---
VARIES
RAD:
VARIES
MATCH %iDT1J
A
R JW L,N=
EXPANSON
JOINTS
s
cO CONTRAC T1ON
B JOINTS SCEWALK
/— CURS JOINITS B
CURB
A `-FACE OF CURB
S'-0� MIN. 5'-0' MIN.
3'-0' 15'-0' MAX 15'-0' MAX 3'-0'
SAN
^USE EXIS TING E* ,;'�'ON JOINT
OR �
WCJT AND ?LACE COLD
JJOINTf_ I—I/2' EXPOSURE
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ELEVATION 8-8 I
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2' OF COMP,a:-D 3/4•_0' AGGRO_cA'iz'
,
SHALL � ERC(",L M(X.
J^INT Si-!_,,I i E A —lROyELZ':) JOINT WTH A MINIMUM =:;uIUS
ALONG SACIK Or CUR?. 1/2'
EXPANSION '}DINS 5-'Ai-L BE 1 2' -REMIMPREGNA=^
MA i�'--IAOLDED ASPHALT
L Gr t:UAL, EXT':NDIN� r"r CM SJSGRADE TO FINISH GRACE
RESIDENTIAL -, DRIVEWAY
DRAWN BY
Cil' OF TIGARD "' Z{ CwZ00PN,CMC
S.�g DATE
-- Of?EGaN DWQ FILE
�`,� 7-9-93 'DETAILS\ Sp—OWDIMC
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GENERAL NOTES
1. TRAFFIC SIGNS TO BE 48' X 4.8'
O BL.ACX ON ORANGE.
100' I 2. NO COLLECTOR STREET LANE; CLOSURES
MIN. OR LOCAL STREET CILOSURES DURING
THE FGLLOWING 71ME PERIODS:
AQ Mc O
920-$ 7:30 -- 8:30 Am.
1� I 4:30 - 5:30 P.M.
MIN.
,l„QX, M4EAo I O I 3. THE CITYS STANDARD SPECIFICATION
C8 'A T FOR TRAMC CONTROL. 15 'MANUAL
100' ON UNIFORM TRAFFIC CONTROL
MIN. I DEVICES FOR STREETS AND HIGHWAYS",
l U.S. DEPT. OF TRANSPORTATION,
U- FHUA 1988 EDITI,tN.
Q
100' FLAGGER 4. ACTUAL SIGN PLACEMENT TO CE
MIN. ■ ■_ ADJUSTED IN FIELD.-
00 NOT REDUCE
■■ 50' MIN. BELOW MINIMUMS ',NlTHOUT CITY
12' 1■— APPROVAL
411N. i
■ 5. THE CITY RESERVES 7HE RIGHT TO ADD TO
■ 1 OR MODIFY TRAFFIC CONTROL REQUIREMENTS
" MIN, z AS MAY BE NECEOSARY TO EFFECTIVELY
■ I V) CONTROL TRAFFIC AND TO ENSURE PUBLIC
FLAGGc� ■ 0 SAFETY.
U-
< 6. NO LANE CLOSURES WITHIN 200 FEET OF
A TRAFFIC SIGNAL 'MTHCUT PRIOR CITY
MIN. 0 APPROVAL
z
O a�w .»vn ___
ICM--?A
100'
MIN. LEGENL'
O I ac uic I
.2D--. Q TRAFFIC SIGM
1 co,
MIN. 0 CONSTRUCTION ZCNE
O 1 we ��� 0 TRAFr1C CONES OR
"`AO APPRCPRI,A i t DELINEATION
DEVICE
TRAFFIC CONTROL
TYPICAL G ETAI L
;r NCE C7AWN Err
CITY OF T I GAR D GM C.Aa
s-kE DArL 9wc FILE
OREGON ItT s. 7-9-92 ,kDEr/RM=WoWv
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 Mach. Shear/Sheath Framing -Mech.✓
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct, Gi;rh Ro11GhAn Gyp. Bd. -Bldg.
San. Sewer ""G`as`LTiS�'"'-� Appr/Sdwlk Reins.
Other: –�
Date: ___ A.M. P.M. Entry:
Address:
Tenant: . —_ _ Ste:__ MST:
_
BLIP:
Con/Own:
PLM: _
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inue r: ---- Date: �����
PPROVED _.DISAPPROVEDICALL FOR REINSP. CF CO
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oropon 07223.8199 (503)839-4171
C'INCBROOK Tk. 7PAC
. . . . , . . , .
-- .r .,,r (` r'. . .�� ',1rn'-rt� 'r:/O t�l�'rl, � m • -. . 1-,—,..r� .�,
.. eBf1
l BTU 1 iii'. . ,� . Z 1' ! it. _.^ 0
. . . . .. f, WCOD;37L'I _ : . . 12I
r,7-.-Ur,E. . . , "k't+ I IC . . CLO Z'r . L`
AAR 1'IONDxLING• UNyTS CTHEr,, UNIT
-• it i00R DTU: I� _ 1l t<'!('t ter _rfl. �� fy,n'. OUTLCT'.:. .
BTU: 0 10000 0
';EDITION rATH
FE,
tdEt<ROO%, SMT 27. 00 .JM1-1 Q 4/01/CJ6 96 :.
JW
'TOTAL
fZCGU I rZCD I NSPEC T, I ON'L
pe ai' ....ed vAject
,.�.F, State of Ore. ,,pecial�j Com=: and all
:;-a::� lays, All wcrk ;.ill be dome in ac.;r•da-xe with '
P:s ., is perait Ail'. a-firF if aero is nct stvlvdl
Aw
-. ("C)76
City of Tigard MECHANICAL PERMIT Planck/Rec. # ij
13125 SW Hall Blvd. APPLICATION Permit # N1c (n ul j
Tigard, OR 97223
(503) 639-4171
•..tJ 0-1w—M Description
Table 3A Mechanical Code OTY PRICE AMT
Job `,Lti7 .,�.c� ,tic'BE'�r,l� 1) Permit Fee -0- -0- 10.nn
Address Y ••
2) Supplemental Permrt 3.00
--- ..,. .^•m.,, ..,... Furnace to 100,000 BTU
') incl. ducts &vents 6.00
Furnace 100,000 BTU 4
Owner 2) incl. ducts R vents 7.50 —�
.. Floor Furnance
3) incl vent 6.00
^„•m. .�••
Suspended ea er, wa iea er
4) or flonr mounted heater 6.00
.•. •• i h-• ent not inc. in
Occupant 5) appliance perm' 3,00
v, Repair of seating, re rig.
6) cooling, absorption unit 6.00
^� Boiler or comp, eat pump, r con
it A- b•�' �,�na w1�1,�' i 1�L 7) to 3 HP, absorp unit to 100K BTU 6.00
--Kr=q • Boiler or comp, hPat pump, air cond.
eC, �j�, ` cl _ C, 0i3, 8) 3-15 HP, absorp unit to 500K BTU 11.00
Contractor Boiler or comp, heat pump, air cond.
tollN Q s�r by r�Y���— 9) 15-30 HP, absorp unit 5-1 mil BTU 1500
Mal •v • • �• •• Boiler or comp, eat pump, air cond.
'1 L C&- 10) 30-50 HP, absorp unit 1-1.75 mil BTU 22.50
-TFere y ac now a ge that I have read this application, th3t the Boiler or comp, Real pump, air con
information given is correct, that I am the owner or authorized 11) >50 HP, absorp unit 1 75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Air handling uni
registration, please give reason below) 13) 10,000 CTM + 750
— — on porta
14) evaporate cooler 4.50
— ent an connected
15) to a single duct 3.00
--- — iib a ion system not
16) included in appliance permit 450
Y19-TI -- ..� Hoodserve y
Lrf 10 j 17) mechanical exhaust 450
escria wore new ✓a ion alteration repair Commercialor rn Ustria
-re
to be done residential Q nosiaeniial Q 18) type incinerator 30.00
-.xisting use of Other i e., woo s ove, Nater
huilding or property 19) heater, solar, clothes dryers, etc 4 50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property _
21) More than 4-per outlet (each) 2.00
Type of fuel -oil Q natural gas/d LPG Q electric Q
NOTICE
Minimum Fee $25.00 SUBTOTAL G C
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SLISDENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY-TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions _ �-'
Date Issued ��_by
N U.00IMOff/1MtCdM1A1'
I1H 11144141 kf- 1 .11!1 111 I'I 1 1"11 N1 l014 11 1 1 f.11.1. b
1411-1 ,k IsHiIIINI ;
RICK A RAYHOHN 1-vOiil 1O-voN1
0.0 Rk.:b j 1 WIS15 Sw SPIRM"'K 1-1 y Hi W I !i I I E. t 4.11 0
AAAD I ').k .ION
TMANDO OR 9 1283--
OF PAYMENT NIVICII-1141 VIHAD P1.fH1!1.1�4 10 PliYPIE-NI (011 11 114 1 PI.111t
(-HANJUAL PE Wel w{f . 1A111I 11 Ili N
IIAlf-W 14MOONt P141
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Hec-O-Phc e). 639-4175 Business Phone: 639-4171 .
Inspection:_
Footing -� Susp. Ceilin Sprink. Ro,gh-ir1/ Appr/Sdwlk
oundati ` Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: I I C� (F TiTe: AM PM
Address:
Builder: Permit #: ,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Al
i
Inspector:_x _ Date:�1��} '
APPROVED DISAPPROVED VED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspect°on Line (Rec-O-Phone): 639-4175 Business Phone: 639-4
Inspection:
ooti _) Susp. Ceiling Sprink. Rough-in A �dwl
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -P,;dc
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. `� -Elect.
Date Requested: Z I �' G Time: 7 AM PM
Address: / U
Builder: _Permit#:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspec Date: .1(�f 9�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE '+
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footi Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Dr fin Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wa I Gyp. Bd. -Elect.
Date Requested:_ �� c Time: AM PM
Address:
r
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�-
,Q/>i7'
Inspector: Date: /L
APPROVED 'fSAPP&OVED APPROVED SUBJECT TO ABOVE
�?a For Reinsp.
1
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ABILITY ELECTRIC INC
PO BOX 889
B.EAVERTON OR 97075
Electrical Signawre Form
Permit # . . . . : MST96--0018
Date Issued. : 02/02/96
Parcel . . . . . . : 2S111AC-00100
Site Address : 09075 SW PINEBROOK ST
Subdivision. : PINEBROOK TERRACE
Block. . . . . . . . I.ot : 42
Zoning. . . . . . . R-4 . 5
Remarks :
ADDITION PATH I
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 -,)propriate individual from your company sign below and return this Electrical
Signature f=orm prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
( VWNER: ELECTRICAL CONTRACTOR:
WAYNE KITTELSON ABILITY ELECTRIC INC
09075 SW PINEBROOK PO BOX 889
TIGARD OR 97223 BEAVERTON OR 97077-
Phone V : 639-8568 Phone .
Reg # 022133
x 1� 09s _ S
Si nat re of Supervising E ectrician
Hrase return this completed form to the address above.
A 1 TN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
MGT96 001
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
131,24,SW HallBlvd.Tlg;krd,O(pon 97223!6190 (503),639-4171 90T 611"k
IVISION. . . . : F'INLBROOK, TLRRACL ZCININ6- R--4. 5
Pi. ;:)CIS. . . . . . . . . . . LOT. . . . . . . . . . . . . : 4 .
Resart:s: ADDITION PATH I
--------------------------------------------------------------- BUILDING -------------------------------------------------------------.
REISSUE: STORIES.......: 2 FLOOR PPEAS--- ---- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED--------- -
CLASS OF WORK.:ADD HEIGHT......,.: 22 FIRST....: 384 sf GARAGE....,: 384 sf LEFT..........: 0 SMOKE DETECTRS: Y
,YPE OF JSE...:SF FLOOR LOAD...., 40 SECOND...: 0 sf FRONT.........: 24 PARKING SPf+CFC;
'YPE OF CONST. ;5N DWEL.ING UNITS: 1 FINBSMENT: 0 sf RIGHT.......,.: 5
OCCUPANCY GRP.:R3 BDRM: i BATH. 1 TOTAL--- 364 sf VALUE-1; 3139.`, REAP..,......... 30
---------------•------------------------- ---------------------- PLUMBING --------------------------------------------------------------
SINKS.........: 0 WATER CLOSETS.: I WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS....,....: 0
LAVATORIES...,: 1 DISHWASHERS... : 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCH BASINS..: 0
?JB/SHOWERS...: 1 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 ECKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER 'IXTURES: 0
--------- - ------------- _..----- -- -... _ MECHANICAL --- -----------------------------_-...---_ _ ----- -
1-UEL TYPES---------- FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS....... 1 CLOTHES DRYERS: 0
/GAS/ / / FURN )=160K, ..: 0 UNIT HEATERS..: 0 HGODS.........: 0 OTHER UNITS...: 0
MAX INF.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 2 WOODSTOVES....: 0 GAS OUTLETS...: 0
---- -- -- ---- --------- -- -------------- ------- ELECTRICAL -----------
UNIT---
---------UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLAfEOUS---- --ADD'L INSPECTIONS
1000 SF OR LESS: 0 e K:00 asp..: l 0 - 200 amp.. : 0 WrSVC OR FDR..: 0 PUMr/IRRIGATION: a PER INSPECTION: 0
EA ADD'L 5W.o 0 201 - 400 asp..: 0 201 - 400 amp... 0 1st W/O SVC/FDR: 1 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 asp..: a 401 - 600 asp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT...,..: 0
MANF HM/SVC/FDR: 0 601 - ;0M amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECT;ON ------------------------------- .
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=22: A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
-------------------------------------------------- - ELECTRICAL - RESTRICTED ENERGY _-.---------------._ --------------------------------
A.
--------------------- ----..-
A. SF RESIDENTIAL------------------------------ B. COMMERCIAL-----------.--------------------------------------------------------------••---
AUD;= & STEREO.: VACUUM SYSTEM-: AUDIO 6 STEREO.: FIRE ALARM.....i INTEPCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: DTH: .s BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE S;GNL:
SAMN OPENER..: CLOCK........... INSTRUMeITATION: MEDICAL........: OTHR: ::
HVAC...........s DATA/TELE COMM.: NURSE CALLS....: TOTAL r SYSTEMS: 0
„ger: --------------------
---------Contractor: --------- -- ------- -- TO!AL FECS:1 463.10
'414[ KITTELSON ROSEDALE. BUILDERS INC
?75 5W FINEBROOK 4810 SW 60TH PL
,3ARD OR 972r-.'3 PORTLAND OR 97221
,one I: 639-6568 Fhone I: 212_5E61
Reg I..: 48475
:s permit is issued subject to the regulations contained in the ?igard Municipal Code, State of Ore. Specialty Codes and all other
':plrcable '.aAs. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180
Sys of it.suance, or if world is suspended for more than 180 days.
-- - -- REQUIRED INSPECTIONS - - _._...._.. - ---------------
_J.t-I.ng
---- __--___Jt:ng lnsp' - -- Mechanical Insp ins:;ation Insp Plimb Final -
mdation Insp Flueb Tap Out Gyp Board Insp Building Final _
ist/Beam Struct Electrical Servi Rain drain Insp Erosion Cont-ol
st/Beae Mechan Framing Insp Electrical nal — ----- - �"
I/Underfloor Law Voltage Mechar' nal _-
1 t f
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1�
Residential Building Permit plication
rlty of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: /1� �.V.� fi i AJ—IZ Qc-r -I
Office Use Only
Subdivision: _[��' ;,nc-�1z:->< 1=��i�.��' Lot# �� •
�., Contact Date l I Initials
Valuation: _ 7(? Result
New Construction Only: (Square Footage) Planck/Rec #
Permit #.1piSryl - !>'Co
House: Garage: _ I _— ,reissue of
Map & TL # ji / C DUIC't'
Corner Lot? N Flag Lot? Y N Zone
�/�� Plat # _
Owner: y\1�1j1l�c� �� N \� ,.7
I Approvals Re ug ired
Address' G`� Lw t 1�JN �te�K
Planning Setbacks Solar _
Engineering
( ) /` -i _ `�� I Other_— --
Phone:
Contractor: ,= t_;1;i;- Items Required J
(� c � 'PSubcontractors
Address: Truss Details —
Other
Notes _
Phone: L -Z AL, ALS
Contractor's License #
(attach copy of current Oregon license)
Contact Name: Lt--de t_
Contact Phone
Subcontractors: Architect/Engineer: Y_
,
1
Plumbing: ��_�11( e(iA. —_ -
�l 'v�.-� � Address:
Mechar,cal. 4;-e `a1 I
(at'ach ropy of cu— rrent OR Contractdr's License)
►,, 1 __lr c 1„� 1`l Phone: { ) ----
JOB DESCWPTION: ;fit 'Ga,c' E _ ! �. X41 ��s��-t:y;�` cJ�v”
r� y
Applicant Signature I T Applicant Phone number
Received b / 'LG lf� Date Received: �j f
Permit x Account Cescripdon Amount Ari. Pd. Bal. Due
`llyG-vat Bldg. Permit (BUILD) ''r. '
Plumb. Permit (PLUMB) ,� _ S-J --
Mech. Permit (MECH) 1- ? 2—
State
-Stag Tax (TAX) -- -
Bldg:
Plumb: __:2,J'
Mach:
Plan Check (PLANCK) 43�
Bldg:
Plumb:
Mech:
Sewer Zonnection (SWUSA)
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKSOC)
Residential TIF MF-R)
Mass Transit TIF MF-MT)
Commercial TIF MF-C)
Industrial TIF MF-I)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water quantity (WQUAN T)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRN i)
Erosion PlanckJUSA (ERPLAN) _
Erosion PlanckJCQT (EROSV)
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ACTIVE CASE: Grp Smry Edit Prcl Name Actn Cond Log-note Fee Doc Tag Misc Xit
List related cases in pr ject group # 7870
OAMASTER PERMITaaaaaaQaaaaaaaAaaaaaaaaaaaaaaaaaa�;aaaaaaaaaaaaaa�aaaaaaaaaaaaaC
° :MST96-0018 : PROJECT:PINEBROOK TERRACE STATTJS :R : UPD: 01/26/96 : :B °
° PERMITTEE:WAYNE KITTELSON P.RIM. . :MST96-0018 : °
° SITE ADDRESS : 09075 SW PINEBROOK ST °
uADESCRIPTION OF PROJECT (1) Aaaaaaaaaaaa�: aaaaaaaaaaaaaaaa.aaaaaaaaaaaaaaaaaaa�
° ADDITION PATH I °
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° REISSUE: DWELLING UNITS : 1 : REQUIRED SETBACKS---.- --- --- - °
° CLASS OF WORK. :ADD: BEDRMS : 1 : PATHS : 1 : LEFT. . : O : ft RIGHT. : 5 : ft °
° TYPE OF USE. . . :SF FLOOR AREAS---------- - FRONT. :24 : ft REAR. . : 30 : ft °
° TYPE OF CONST. : 5N FIRST. . . . : 384 :sf REQUIRED---- - ----- -------- - °
° OCCUPANCY GRP. :R3 SECOND. . . : O :sf SMOKE DETECTORS. :Y: °
° STORIES . . . . . . . : 2 : THIRD. . . . : O : sf- PARKING, SPACES . . : ! : °
° HEIGHT. . . . . . . . : 22 : ft TOTAL------ : 384 : sf °
• FLOOR LOAD. . . . : 40 :psf BASEMENT. : 0 : °
° VALUE. . $ : 31395 : GARAGE. . . : 384 : °
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