11320 SW 94TH AVENUE ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: P 19 1-417;
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line C13 dd ,t.
Plbg. Underfloor Fain Drain Framing -Plumb.
Alarm Water Line Insulation
Underflr. Insul. Shear Wall / Gyp. Bd. -Elect.
Date Requested:_ yam, Time: AM _ PM
Address: 1 3,4L G 2
Builder: 60 Z Permit
THE FOLLCWING CORRECTIONS ARE REQUIRED.
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Inspector. Date - -+—^'
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PROVED 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: CrZ>
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in CIN
Post/Beam Mech. San. Sewer Gas Line Bid
Plbg. Underfloor Rain Drain Framing
Alarm Water Line Insulation - ec /
Underilr. Insul. Shear Wall Gyp. Bd. -Elect.
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Date Requested: Time: AM PM
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Address:^ - &
Builder: q Permit tl: 9y_ U
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ Date: Z
_APPROVED _ ISAPPROVEE _APPROVED SUB J T TO ABOVE
_/Call For Reinsp.
CITY CF TIGARD BUILDING INSPECTION NOTICE ` ,-"'
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Coiling Sprink. Rough-in Appr/Sdwlk
Foundation 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:, /�-S Time: AM PM
Address:
Builder: 6 z�= zi ' Permit tl:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
- CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERM11 #. . . . . . . : M91'94-022(
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)'6194i71 DATE ISSUED: 06/13/04
PARCEL: IS1351)13-07100
SITL 11,3216 bW 941-H HVE
SUBDIVISION. . . . : OINEEL ACRES 7 ON I NG: R-4. 5
BLO01... . . . . . . . . . : LOT. . . . . . . . . . . . . : 11
BUILDING _—_—_-_..-..__-------------_._—_._---_—__-.
RE I SSUE DWELL I NG ON ITS: 1 BASEMENT. . . . . . . . :0 s
CLASS OF WORK. :ADD BEDRMS: 1 BATHS: I GARAGE. . . . . . . . . ..0 5f
TYPE 1JF USE. . . SF FLOOR AREAS- REQUIRED SETBACKS—
f'YPE OF CONST. 51Y F*L RS T*. . . . :400 Sf LEF-1 . . :0 ft RIGHT. :O f1:
OCCUPANCY GRP. : R3 SECOND. . . .O sf FRONT. :0 ft REAR. 0 f I
STORIES. . . . . . . :' THIRD. . . . :0 Sf RFOU I RED—,----
HE I GHT. . . . . . . . :30 ft TOTAL—- 400 S f SMOKE DE.TECTORS. :Y
FLOOR LOAD. . . . :40 p,.f VALUE. . . . . 18400 PARK I NU SPACES. . : i
Remarks : appt-om 400 sq ft addition above giat-age PATH I
PLUMBING
SINKS, . . . . . . . . . .0 FLUOR DRAINS. . . . .0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . : 1 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :0 LAUNDRY 1RnYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . : 1 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LINE ( ft ) . :0 OTHER FIXTURES 0
GARBAGE DISP. . . :0 RAIN DRAIN (ft ) . :IZA
WASHING MAC14. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL FEES
FUEL TYPES--.----- UNIT HTRS. . :0 type amount by date t'Pcpt
/GAS/ VENTS . . . . . :2 BPRT $ 134. 50 JF OZ16/13/94 --
MAX
MAX INPUT-VI) B'T U VENT F'PNG. . . 1 BPLC $ 87. 43 SW 06/07/94 94-25319(
FURN < LOOK . . :0 HOODS. . . . . . e0 B5PC; $ 6. 73 JF 06/13/94 —
FURN ) =100K . . :0 WULAY�i I UVLS. :0 M PH T $ 26. 50 Jr 06/13/934
FLOOR FURN. . . . ..0 CLU DRYERS. e 1 MPLC 6. 63 JF 06/13 '94
BUIL/CMP ( 3HP:O UIHER UNITS:0 M5PC is 1. 33 JP 06/13/94
GAS OU'TLE',S:@ PPRT i, 37. 50 JF 06/13/94
Divnet,: 1. 88 JF 06/13/94
DUANE & KRYSTI JACKSON
11320 SW 94TH nVE'
rI9PRD OR 97223
Phone #: 6811-9326
OWNER
---_---------------.-------------------
$ 302. 50 TOTAL
This persit is issued subject tc the regulations contained in the ------- REUUIRED INSPECT TUNS
Tigard Municioal Code, State of Ore. Specialty Codes and all other PLM/Under-f loor, PILtmb FinAl
app:licable laws. All work will be dope in accordance with avorovpd Mechanical Inap BUilding Final
plans. This persit will expire if *DIk is not started within 160 P11-imb 'Top Out Erosion Contt,oi
days of issuance, or, if work is suspAded for rare than 180 da s. Framing Insp
Insijlat ion Insp
-' ittee Signiat "I Gyp Board T"Sp.
-
Rain drain Insp
--10 d i!y Mechanical Final
For inspection - b39-4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobs!te Address:
Office llse OnIY
Subdivision: /1 1 lrlS 1.,;i # _ ,
Valuation: l/nJ PlanckJRec #
Permit #
Owner: S
,,nn1 1 Reissue of _
Address: CIA f Map & TL #
Phone: CC Approvals Required
Planning
Contractor: -- Engineering _
Address: Other
Phone: Items Required
Contractor's License # Subcontractors
(attach copy of current Oregon license) Truss Details
Contact name & phone: Other
Subcontractors:
Plumbing: (�7W-ss-\o Ay- _
Mechanical: ��_1 ^J..YNN ) V. _
(attach copy of current OR Contractors License)
ArchltecVEnglneer:
Address.
Phone:
JOB DESCRIPTION: ___L-\-
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Appl nt Signak-ire & Phone ritimber
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Received by:i Date Received:
Pennit Account Description Amount Amt. Pd. Bal. Due
nSi y a2 Bldg. Permit (BUILD) /-3�')V
Plumb. Permit (PLUMB) �• / 3
Mech. Permit (MECH) �
State Tax (TAX')
Bldg: 6• ✓
Plumb: /
Mech:
3
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA) _.
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKSDC) _
Storrs Drainage Chg (SDSDC) _
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) _
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Oft ice TIF (TIF-0)
R
Water Quality (WQUAL)
Water Quantity (WOUANT)
Fire DistriA (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion PlanckAJSA (ERPLAN) _
Erosion Planck/COT (EROSN)
TOTALS:
INSPECTION NOTICE
City of Tigard Building Depart—t
13125 SB Ball Blvd. Tigard, oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection: _ -- _ -- —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FIVKL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. ain_Drsin� Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: l/�f T/l/qty --Timet .[ :3u PH
Address:1f 17 Permit t:A1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainsp.
INSPECTION NOTICE
City of Tigard Building Departs:int
13125 Sw Ball Blvd. Tigard, Oregon 9il?3
Inspection Line (Rec-o-Phone): 639-4175 Business (tone: 639-417
Inspection: _
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -bldg,.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Linea -Meeh.
Date Requested: /L, U T Timet [� AM PM
Address 3 Z - I t -- Permit I: / - Z
B Ung ��
THEEINJL.OWINO CORRECTIONS ARE REQUIRED:
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Inepsctor: ''- � � _ bates �� -i+�� _�/Q
GA�PROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Painsp.
INSPECTION NOTICE \
City of Tigard Building Depart—t �»
13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buoiness Phone: 639-4171
Inspection: ----
Footing Plbg. Underslab ech. Rouy-rn] Appr/Sdwlk
Found. Plbg. Top _ GamLineFINALS
Poet/Ream Su t. San. Sewer Framing -•Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor WaterLin Gyp. Bd. -Mech.
Date Requested: 'E Times S2 /�Ph
Address:w' cT& 7 1 / ✓ Permit fsl/f•?[ !��O��iP
x„s Last:
THE FOLLOWING CORRECTIONS ARE RRQUIREDiCA
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Inspector: �, N Datse
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APPROVED V DIS"PROM --.--- APPROVED SUBJECT TO ABOVE�
Call For Reinsp. 0 _ p~j
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97271'
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Qndersleb Mech. Rouqh-in Appr/Sdwlk
Pound. Plbg. Top Ou Gas Line FINAL-
Post/Beam Struct. San. Brower Framing -Bldg.
Post/r m Mech. Rain Drain InBulatioii -plumb.
Plbg. kdarfl.00r (Water
p Line Gyp. Bd. -Mech.
Date Requested: QD D ( t�`�1' Time: AM �+� / ^p14
Address: / j �((� {�Q'�i ��11�4 t/O�0-1-
Permit �7
Builder:_ �!' "
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector
s - PBater
)e—AJPPR0VMD DISAPPROVED APPROVED SURJRrT TO ABnVB
�--Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departwftnt /
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (ReO-Phone): 639-4175 Business Phone: 639-4171
c:-
'.nepection:_
Footing plbg. Underelab . Rough- Appr/Sdwlk
Found. Plbg. fop Out Gas Line FINAL:
post/Beam Struct. San. Sewer ranine / -Bldg.
Poet/Beam Mech. Rain Drain t"-Tneulat•i.o$ _� -plumb.
Plbg. Underiloor Water LineGyp. Bpi. -Nech.
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Date Requented: , 1/ -7(f I- ,Tune: _�AM _�PH
7ry1.5T
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Address: �� U T `' _ Permit I.
Builder:
THE FOLLOWING CORR.3GTIONS ARE'. REQUIRED: I
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rnnpectors Date:
/APPROM �-- DISAPPROVED APPROVED SUBJECT TO ABOVE
CalI For Reinsp.
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CITY OF TIGARD
BUILDING DIVISION
RESIDENTIAL PLANS SUBMITTAL
1
A( PLICAN1 NAME: PLAN CHECK
ADDRESS: 1' �1C� `�l� ,. C�i-I. k PHONE n '
DATE RECEIVED: _ ( RECEIVED BY:
CHECKLIST (All items must b% in packet before plan will be reviewed)
YES NO N/A
1 V ( ] ( ] 3 FULL SE fS OF BUILDING PLANS (No red line revisions
or tape-ons).
2. 5 SITE PLANS (including tax lot and tax map number,easements,
erosion control provisions, floor elevation or garage and main
floor, set It.j,-ks, drive-way location, north arrow, scale, location
and termination of rain drains, corner elevations, and ontours
if over 15% grade).
3. J [ 1 BUILDING PLANS SHAI L REFLECT TOPOC,.,,PHY OF LOT
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
4. [�1 [ ] [ ] REVISION TO PLANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (detailed sections may be
different from the originals as a result of your changes. These
d portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
N
5. FLOOR PLAN(S)
6, [ ] [ J FLOORFRAMING
7. A<] [ ] [ ] TRUSS JOISTS (engineering, details and layouts)
8. �✓1, [ ] [ ] ROOF FRAMING PLAN (all hips and valley supports indicated
�`" and detailed).
9, [ ] j ] [ ] ROOF TRUSSES (engineering, details and layouts)
10. ( J [ ] [ J COMPLETE CROSS SECTION(S)
11. [ j [ J [ ] ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] [ ] [ ] BASEMENT WALL, FOUNDATION AND RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [ ] [ ) [ ] WALL BRACING (structure must meet table R-402.10, revised
alternate method 93-7, or a lateral design shall be provided)
14. [ ] [ J [ ) ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the plans).
15. [ ] [ ] ( ) BEAM 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 CORRECTION IN RED
RED WILL ONLY CAUSE DELAYS
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F Permit No: _
Address:
Issued by:. Date:
--FOR OFFICE USE ONLY_
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment 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 applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
1 . CN I own, reside in, or will reside in the cor pleted structure.
2. DI understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon compiotinr.
3. A.I7 My general contractor is----
Contractor
s Contractor registration number -
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board
OR
3. B. I will bb my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Gonstruc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the office issuing this building permit of the name of
the contractor.
—' 1 hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
,LD reverse side of this form.
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�S g atu of P mitt p rcan T Date -
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT