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CITY OF TIGARD BUILDING INSPECTION DIVISION MST _C3y 5 -0013j
24-Hour Inspection Line: 6394175 Business Line: 639-4171
r _
Date Requested �7 7.'�j�� AM_ _PM BUP
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i BLD _
Location Suite MEC _
Contact Person �`7LZl Ph (0�� ! ' PLM
Contractor Ph SWR
IN LDlW Tanant/Owner ELC
Retaining Wall ELR
Footing —
Acc==ss:
Foundation ST FPS
Ftg Drain SGN
Stab
Crawl Drain Inspection Notes: ( �,j� —
SIT
Post&beam l
Ext Sheath/Shear _
Int She4th/Shear
Framing
Insulation
Drywall Nailing
Firewall T
Fi,e Sprinkler
Fire Alarm
';usp'd Ceiling
Roof
Mis -- _ - - ----- _
PART FAIL ------------ - --_--__ _ _
oN &Beam
Under Slab _
Top Out —
"later Service _
Sanitary Sewer
Rain Drains
':& PART FAIL
MECHANICAL
Post& Beam -
Rough In
Gas Line -- ---
Smoke Dampers
Final --
PASS PART PAIL \
ELECTRICAL
-. Service
Rough In
UG/Slab
Low Voltage
- Fire Alarm -- -- -_ _ _-. —• _ -
Final
PASS PART FAIL -
SITE
Backfill/Grading —-------- ----
Sanitary Sewer
Storm Drain I j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I j Please cell for reinspection RE. _ I ]Unable to inspect-no access
Fire Supply Line --
ADA
Approach/Sidewalk
Other _ Date -_(J Inspector_ Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
� MASTER PERMIT
Y OF
T'G A R D
PERMIT#: MST1999-00137
DEVELOPMENT SERVICES DATE ISSUED: 4/19/99
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639.4171
SITE ADDRESS: 11785 SW 91ST AVE PARCEL: 1S135DC-02400
SUBDIVISION: ZONING: R-7
BLOCK: LOT: JUr-ISDICTION: TIG
REMARKS: Fire damage repair. No Plans required - Work consiss of(a) Replace rafter t,3 is, (b)Sheet rock which
inclusdes 5/8X to the 1-hour occupancy separation wall, (c) replace 3 sheets of exterior sheathing,
BUILD:NG
REISSUE- STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: REP HEIGHT: FIRST: of BASEMENT: sl LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: S_C0ND: of GARAGE: of FRONT: IAPvING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENI: sf RIGHT:
VALUE: $28,000.00
OCCUPANCY GRP: R3 BDRM: 3ATH: TOTAL: of REAR:
PLUMBING _
SINKS: I WATER CLOSETS: I WASHI' ,MACH: LA',NDRY TRA)S: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LIN'-S: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS: I GARBAGE DISP: WATER HEATERS: WATER'-INES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 100K: BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER:
FURN>-100K: UNIT HEATERS: HOOD: OTHER UNITS:
MAX INA: bhi FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BVANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR'.ESS: 0 - 200 arnp: 0 200 amp: 1V/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 400 amp: 201 400 amp: let N/O SVC/FDR: SIGN/OUT LIN LT: PER HuUR:
LIMITED ENERGY: 401 600 amp. 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HM/SVC/FDR: 601 - 1000 amp: 601-amne•1000v: MINOR LABEL:
1000.amplvolt:
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC/FOR> 225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL. _ _ B.COMIAERCIAL
AUDIO$STEREO: VACUUM SYSTEM: AUD.0-STERcO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LN.SC LT:
BURGLAR ALARM: OTH: BOILEW HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL
GARAGE OPENER: CLOCK: INSTRUMEN1ATION: MEDICAL: OTHR:
4VAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: $ 393.65
Owner: Contractor: This permit is subject tc the regulations contained in the
HOUSING AUTHORITY OF OREGON HOME IMPROVF_MENIT COTigardMunicipal Code.State of OR. Specialty Codes and
WASHINGTON COUNTY 17255 SW PILIONGTON RD all other applicable laws All work will be done in
111 NE LINCOLN ST#200-L LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expired
HILLSBORO, OR 97124 work is not started within 180 days of issuance,or if the
i- work is suspended for more than 180 days. ATTENTION.
Phone: Phone: Oregon law requires you to follow rules adopted by t1-3
Oregon Utility Notification Center Those rules are set
emir: LIC 00034906 forth in OAR 952-001-0010 through 952-001-0080 You
—' may obtain copies of these rules or direct questions to
CAO OUNC by calling(503)246-1937
r� REQUIRED'NSPECTIONS
tL
Electrical Rough-in Gyp Board Insp
Plumbing Top Out Electrical Final
framing Insp Plumb Final
Insulation Insp Building Final
Exterior Sheathing Insl
Issued By ��- Permittee Signature
Call (5039-4175 by 7:00 p.m. for an inspection needed the ext business day
04 08 99 TIT 08:.7.0 1.11 503 598 1960 CITY OF TIc:1w) IM 002
CITY OF TIGARD Residential Building Permit Application Plan cheek*
13125 SW HALL BLVD. Alteration - Interior Remodel Only Oate Re�-��-
date Rec'd_�!��
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P E F
V 503-639-4171 Date to DST l
F 503-684-7297 Permit rt/-19T-1 9 99-cam r 37
Print or Type —
Incomplete or illegible applications will not be accepted
Name of Project _-- Name �- -------- - - --�
.lob ( ►L�. 2�;b ''�{��chitect Mailing Address
Address Site Addjpss J�
CitylSlate Zip Phono
arae
O t�� - - Name— -
Owner Mailing Addr ss
Y S ( Engineer Mailing Address
C ($tat Zips Phone 11�
Z �s-'I City/Slate Zip Phone
General Name
Contractor \' Describe work New 0 addition O Alteration O Repair
Mailing Ad,:ress to be done41L"'—
Prior to permd -�1_ f �KJ/1 O✓1 Additional Description of Work
issuance,a copy City/State 1 Zip Phoneof all licenses 1 0
are required if Oregon Const.Cont.Board Err .Dale PROJECT
expired in COT Lic# 7 VALUATION
database - ---
Mechanical Name NEW CONSTRUCTION ONLY:
Sua- Sq. Ft.Ilouse Sy Ft.Garage
Contractor Mailing Address I -
- Indicate the restricted energy installation by the electrical
Poor to permit
issuance.a copy City/Slate Zip Phone subcontractor in the followin areas
of all licenses Restricted Audio/Stereo
are required If Oregon Const.Cont.Board Exp.Date Energy _ S stem Alarms
c.pired in COT Lic.0 Installations Vacuum Irrigation
_database S stem _ System
Plumbing Name (check all that Other.
r
Sub- �... _,� _ a I
Contractor Waiting dress Omer Lot YES NO Flag Lot YES NO
check one (check one)
D� O ^ �. r Has the.Subdivision Plat recorded? N/A YES NO
Prior to permit _Cttylstate Zip f'hon
issuance a copy r�- r r /l c7 70 w`/ Solar Compliance
of all licenses are Oregon Const.Cont Board Exp.Dale (Calculation Attached)
required if Lic.
expired In COT l_;'I_ 0 -11 U 1 Nearby acknowledge that I have read this application,that the
database, ,, Plumbing Llc.K cep.Oat information given is correct,that I am the owner or authorized agent
of the owner,and that plans submitted are in compliance with
Oregon State laws.
Name r Slgripture of Own nt qtr 4 �
Electrical �� '
� Mailing Address �eraon Na Phone aY
.., Sub g f10 -747V
Contractor (.���. L �! f�l. _FOR OF ICE USE ONL
City/Stale Zip Phone tat III: Map/TLIt'
ILD Prior to permit ) r�.. �S/ -
i issuance,a copy �izcu 01[ �m J• ^ �/� Setbacks' 2onc. /�_ Solar:
of all licenses are Oregon Const Cont Board Exp.Date A
Solar-
required if Lic.N -
expired in COT A- 7 Ca Eng rifted ng provel: Planning/1�proval: TIF:
database Electrics Llc N Ex Dal _ -
211_j- P,o���- O 1 r
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ZFREM2 DOC(UST)8/11/98
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