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11590 SW 95TH AVENUE i �� i � c !� 'n i I I�'Illti�� 1;�� 1 � - CITYOF TI GA R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00257 13125 SW hull Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/16/01 PARCEL: 1 S135DC-03200 SITE ADDRESS: 11590 SW x)51-H AVE SUBDIVISION: FIRDALE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF KNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS WIO APPL: VEN T SYSTEMS: STORIES: _BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAw7PCEPS?: 30 - 50 HP: V:OODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU. AIR HANDLING UNITS_ OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS > 10000 ctm: Remarks: Installation of exterior A/C unit. Cannot be placed within the required set backs. Owner: FEES___ WINTERS, JOHN W Type By Date Amount Receipt 11545 SW GREENBURG RD pRMT CTR 7/16/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 7/16/01 $5.80 272001000C Phone: Total $78.30 Contractor: REQUIRED INSPECTIGNS Mechaniuil Insp Phone: Cooling Unt Insp Reg#: Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-91,89. Issue By: -'• / t�, ;L Permittee Signature: ��L-1 �� - IJ} Call (503)639-4175 by 7:00 P.M. for Inspections needed the next business day Mec►Aanical Fermin Application City of Tigard —_777 A Dateieceived: f s ' Permit no.: ; Address: 13125 SW Hall Blvd,Tigard,OR Project/appl.no.: Cir y n(7 igurJ Expire date: Phone: (503) 639-4171 Date issued: Fax: (503) 598,1960 BY`- Receipt no.: Case file no.: ay Land use approval: Pment type: Building permit no.: —l- -- -- it 1 U 1 &2 family dwelling or accessory U Commercial/Industrial U New consinlction U Addiiion/alteratiolt/re lacement U Multi-family U Tenant improvement Millp J Oflier: 1 - — Job address: e� 1; Jai 1 1 Bldg.no.: - Ve v� >Z Indicate,quipmeill quanliues in Suite no.: buses below. Indicate the dollar Tax map/tax lot account value of all mechanical materials,equipment,labor,overhead, Lot: profit. Value$ Block: Subdivision: �— ----- Project name• 'Sec checklist for important application information and City/county: ---- jurisd'iction's fee schedule tris residential permit fie. ZIP: Description and location of work on premises: 1 o -- t Est.dart of completion/inspection: ---- Tenant improvement or change of use: iI"(r•l ► t rt•ll Ikur'pto° (il}. Nls.only ttrr.unlr� Is existing space heated or conditioned?U Yes U NuC, g unit --- Airhandlin _,CFM Is existing space insulated?U Yes U No r con uionmg(sit!pan require ) lerntion o extsuog C system I ---1 Business name: o er compressors J - State boiler permit no.: Address: -�- HP -- Tons BTU/H J City State: it i c arnper, uct smo a etectors ZIP: co}� Pump Phone: --- p mp(she p an require ) I'ax: E-mail: nsta rep ace urnace usher CCB no.: - Including ductwork/vent liner U Yes U No City/metro tic,no.; ----`--' - - — nsta /rep ace re ocale caters-suspen e , Name(please print): - wall,or floor mounted crit for a iance of er t an urnace - e gest on: Name: ��. t Absorption units BTU/H -- Address: r '- i Chillers Hp _ Com ressocs h City• A` State: - nv ronmenta ex ust Phone: ZIP: 3 H Fnx: Appliance vent an rent at, ri-mail: ryerex gust ---- 00 s, ypc res. nc en razmat Name: C hood fire suppression system Mailing address: e t Exhaust fan with single duel(bath tans) `- Ci(y: - ve. :x laust S stern a art rom catin or C b PhState: Q. ZIP: Ue P P n one: g an 0 ut on(up to out ets) C a Fax: )..i L' mail: TY _ LPG NG uc .i mtnc a itinna ovcr4outcls -- Name: rocessP P ng(schemaucrequire Number of outlets Address: - t er app ante or equ pment: City: Decorative fireplace Stale: ZIP: nscrt-t c Phone; fax: E-Mail: oo stove pe etstove Applicant's signature; cr: NameDate: (print): Na all Juridiclions accelN cralil cants,plrase call Ju Nerlictlon for nesse infonnellon U Visa 1.1 MasterCard Notice:This permit application Permit fee........ ..... ...... r«du ted number: -( expires it's permit is not obtained Minimum fee......... ...... Nsme of ce creditOwn on ` _ =xr n+rcs within ISO days after it been Plan review(at __ 9(,) - l - has been p State surcharge(896 �- accepted as cum fete. )•...$ �` "rr — _ tune_ S J - — TOTAL -- _ --- Amount ...........$ —=- yJ_ 440617(60W-oM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMiLY DWEL JNG FEE SCHEDULE: - _ ___ - - -� Description: Price Total TOTAL VALUATION:JT FEE: Table 1A Mcchanical Code dry (Ea) Amt $1.00 to$5 000.00 Minimum fee$72.50_ ._ _ 1) Furnace to 100,000 BTU 14.00 $5,OG1.00 to 510,000.00 $72.50 for the first$5,000.00 and Includin ducts&vents $1.52 for each additional$100.00 or 2) Fumace 100,000 BTU+ '17.40 fraction thereof,to and including including ducts&vents $10,000.00. 3) Floor Furnace $10,001,00 to$25,000. 0 $148.50 for the first additional $1 0- and Includin vent 14.00 $1.54 for each additional$100.OG or 4) Suspended heater,wall heater 14.00 fraction thereof,to and Including or floor mounted heater $25000-00. 5) Vent not included in appliance permit $25,001.00 to$5Q000.CO $379.50 for the first$25,000.00 and 6.80 $1.45 for each additional$100.00 or nits fraction thereof,to and including 6) Repair u12.151 _ $50 000.0_0._____ Check all that apply: Boiler Heat Air 550,001.00 and up $742.00 for the first$50,000.00 and For Items 7-11,see or Pump Cond $1.20 for each additional 5100.00 Gr footnotes below. Com fraction thereof_ - 7)<3HP;abs rb unit 1400 _ to 100K BTU - ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb 25.60 Value Total unit 100k to 54k BTU Desai tion: Qt Ea Amount 9)15-30 HP;absorb 3500 Furnace 10 100,000 BTU,in^ clr+ding 955 unit.5-1 mil BTU ducts&vents - 10)30-50 HP;absorb 52.20 Furnace>100,000 BTU including 1.1'0 unit 1-1.75 mil BTU ducts&vents 11)>50HP:absorb 87.20 Floor furnace includin vent 955 unit>1.75 mil BTU Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM 10.00 floor mounted heater Vent not Included in applicance 445 13)Air handling unit 10,000 CFM+ 17.20 permit _ 805 W Repair units 14)Non-portable evaporate cooler 10.00 <3 hp;absorb.unit, 955 to 100k BTU __ 15)Vent fan connected to a single duct 6.80 3-15 hp;absorb.unit, 1.700 101k to 500k BTU _ 16)Ventilation system not includod In '1000 15 30 hp;absorb.unit,501k to 1 2,310 a Ilance ermit mil.BTU 17)Hood served by mechanical exhaust 1000 30-50 hp;absorb.unit, 3,400 1.1.75 trill.BTU ---- 18)Domestic incinerators 17.40 50 hp;absorb•unit, 5,725 1.75 mil.BTU - 19)Commercial or Industrial type Incinerator 69.95 Air handlln unit to 10'000 cfm 65rs Alr handlln unit>10 000 cfm 1 170 20)ether units,Including wood stoves 856 10.00 Non- rtable evaporate cooler Vent fan connected to a kiln le ^ 446 duct 21)Gas piping one to four outlets 5.40 Vent system not Included in 658 a II^n��It 22)More than 4-per outlet(each) 1.00 Hood served b mechanical exhaust 658 1 Domestic incinerator ,170 Minimum Permit Fee$72.50 SUBTOTAL: Commercial or Industrial Incinerator 4,590 5 Other unit,Including wood stoves, 656 8'/.State Surcharge inflects,eta. - 360 Gas 1 In 1-4 outlets _ - 25'/.Plan Review Fee (of subtotal) 63 Required for ALL commercial permits only Each additional outlet TOTAL COMMERCIAL s TOTAL RESIDENTIAL PERMIT FEE: s VALUATION' -__ - --- Q(hgrI_nsueg ons and Fsas: 1 inspections outside of normal business hours(minimum charge-two hours) $72 5o per hour 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum rharge-one-half hour)$72 50 per hour 'State Contractor Buller Certification requited for units>200k OTU. "Residential A/C requires site plan showing placement of unit i:\dsts\forms\merh-fees doe 10/11/00 /`__ � / ` 1 1 y E l� :f _-- a t � ` � i � V I i s i t V d O coo n "• o C• /V w o � G a o '> r.r tv n n n o r O a � o Q o � n a A b a' tin CITY OF NGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-41755 G Business Line: 639-4171 BUP Date Requested �/ / AM PM BLD Location f �> Suite MEC Contact Person Ph PLM Contractur Ph SWR — ELC BUILDIN Tenant/Owner - ELR _— Retaining Wall Footing Access: FPS — Foundation Ftg Drain SIGN _ Crawl Drain Inspection Notes: SIT Slab — - Post&Beam Ext Sheath/Shear — Int Sheath/Shear Framing ^�— Insulation Drywal'Nailing -- Firewall _�— Fire Sprinkler Fire Alarm Susp'd Ceiling -- Roof Misc: rn 0SS/ PART FAIL MBING Post&Beam Under Slab — 'rop out Water Service Sanitary Sewer Rain Drains Final _. PASS PART FAIL MECHANICAL Post&Beam — Rough In Gas Line T Smoke Dampers _ - Final -- — PASS PART FAIL ELECTRICAL Service --- -- Rough In UG/Slab — Low Voltage Fire Alarm -- Final PALS_ PART FAIL IT Backfill/Grading 4 Sanitary Sewer 0 Storm Drain I ( ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd . �� Catch Basin ]please call for reinspection RE.r ( ]Unable to Im pect-no access Fire Supply Li ie ADA ^O� Ap oach�Side alk Date 'J� (,f I Inspector Ext - l he 1J1.1/�► f�('dS�' Fin ss , PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIG RD 24-Hour BUILDING Inspection Line: (503) 639-4175 j INSPECTION DIVISION Business Line: (503) 639-4171 -f A:f"'�- MST 0 _ � 1y3 BLIPReceived Date Requested-___ � I App -------� - B U P Location �. �S � U ��S`1�- �..� - Suite MEC Contact Person f �-,� Ph( ) PLM Contractor Ph( ) - SWR BUILDING Tenant/Owner -- Footing - _ __ ELC Foundation Ftg grain Access: ELC - Crawl Drain ELR _ Slab Inspection Notes: Post&Beam SIT Shear Anchors -- — - -- - Ext Sheath/Shear -- Int Sheath/Shear Framinq _ - Insulation - �- Drywall Nailing - Firewall -- --- - Fire Sprinkler Fire Alarm Susp'd Ceiling - -- - Roof ----- --- Other: - Final PASS PART_ FAIL �- PLUMBING- — - Post& Beam --- - Under Slab Rough-In - Water Service _ Sanitary Sewer -- - Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASSPART FAIL__ MECHA_NICAL. e Post$Beam - - - Rough-In Gas Line Smoke Dampen - ----------...-------------- - Final PASS PART FAIL_ ------_-_. ELECTRICAL Rough-In UG/Slab - - Low Voltage - F5r&Alarm -------- rpproachi/Sidawalk PART FAIL lJ Reinspection tee of$-�_ required before next inspection,. Pay at City Hall, 1;125 SW Hell Blvd, Please call for reinspection RE:____ ply Line -' --- -- E l Unable to inspect-no access Date rZ'� � - c� I�speeft � -- _ LFinal DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Ir,sPctian Line: (503) 639-4175 MST _ INSPECTION DIVISION Business Line: (503) 539-4171 BUP CI Received ___ Date Requested FL—_ AM-- PM. BUP _ Location Lc �1�_ �5 — Suite MEC Contact Person h _____ Ph( ) Fq PLM Contractor _ _ __ Ph(� _) SWR BUILDING Tenant/Owner - -___ _-__ - -_- _ -_ ELC — Footing ELC Foundation - - Access: Ftg Drain EL.R Crawl Drain _ Slab Inspection Notes: SIT --- Post&Beam _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing --- Insulation Drywall Nailing - -- -- Firewall Fire Sprinkler - - -- Fire Alarm — Susp'd Ceiling -- — Roof Other. ._.PART FAIL — -- -- -- PLUMBING Post&Beam Under Slab ------ — -- -- Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other. — Final PASS PART FAIL MECHANICAL Post&Beern - --- - - ------ - -- �— Rough-In Gas Line Smoke Dampers — -- Final PASS PART FAIL _ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final C� Reinspection fee of$ _ required before next inspectlor. Pay at City Hall, 13125 SW Hall Blvd, PASS PART FAIL SITE _ Ll Please call for reinspection RE: _ ❑ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Doe-_Z Inspector __ Ext Other: Final DO NOT REMOVE this Inspection record from the job sites. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST 3 /3 _Cate Requested /— 3 AM PM i BLD Location //} ,fU 5 w S d /11ci✓ Suite MEG Contact Person Ph S7J3 �i'Y ? & v'� PLM ` Contractor Ph SWR UILDIN Tenant/Owner _ ELC Retaining Wall i ELR - Footing Access: -- Foundation FOS Ftg Drain — --- Crawl Drain Inspection Notes: SIGN Slab — --------- Post&Beam --- SIT Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing/ Firewall - Fire Sprinkler� Fire Alarm , ,(•J Susp'd C ing Roof /l - Misc: GOiM- ina -- PART AIL PLUM IN Post& Beam ---- -- --- ---_�_ _—.—__ --- Under Slab Top Out — ----_ __ ----- — __ - Water Service Sanitary Sewer R Drains PART FAIL MECHANIC ---- —--— -- Post& Beam -- al Rough In Gas Line Smoke Dampers — -- -- --- __� ) PART FAIL ---�--~�— - ~----'-- ELECTRICAL Service _ t� Rough In UG/Slab Low Voltage -- Fire Alarm Final —.--- Ockfii�ll/Grading IL — ( Sanitary Sewer ov Stc,m Drain . '�� ^` [ ]Reinspection fee of$ _required before next inspection. Pay at ;ity Hall, 13125 SW Hall Blvd Catch Basin W Fire Supply Line [ I Please call for reinspection RE: _ ( J Unable to inspect- no access ADA �7 , ("� _ �'� SApproach/S al I�.�S ate 1 I d Q V f..-ti v _�' Ext-' Inspector_ —_ Fi ---- Ass PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639"4175 Business Line: 639-4171 MST l_o9� -_ PUP Date Requested / v e ------- B L D Location //S 9G' S' ��- ;�� tE Suite ------- MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Ovine' ELC -- Retaimnc�Wall ----- -- - Footing ELR Foundation Access: - Ftg Drain I FPS Crawl Drain Inspection Notes: SGN Slab Post& Beam --- -. SIT -----`- Ext Sheath/Shear ----- Int Sheath/Shear Framing Insul:jtiun _ Drywall Nailing - - Firewall Fire Sprinkler Fire Alarm -- Susp'd Ceiling Roof Misr,: T -- 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 ---- .r�.-_�-- Gas Line _-- Smoke Dampers _- Final PA_S AIL - ------- - CTRICAt,---r --- - - — �_ wire - - ---- Rough In --- - - _ UG/ollab Low Voltage Fire Alarm A3 ART FAIL 7Sanitary Grading Sewer —Drain ( j Reinspection fee of$ required before next ins Pction. Pay at City Hall, 13125 SW Hall Blvd Catch Basin - p- Fire Supply Line f I Please call for rQingpectiun RE: ADA // -- - --------_ I j Unable to inspect•-no access Approach/Sidewalk F lnalr _ Date i Inspector Ext _ _. PASS PART FAIL DO NOT REMOVE this inspection record from the job site. COLI ENGINEERING and Construction Services, Inc. Street Address: 9025 Southwest Center Stieet Mailing Address: P.O. Box 23784 •Tigard, Oregon 97281 (503) 620-2086 • FAX (503) 684-3636 April 14, 2000 Job#. 99-0709 City of 1 igard ATTN: Rick Bolen, Inspector II 13125 SW Hall Blvd Tigard, OR 97223 RE John Winters Residence 11590 SW 9511' Tigard, OR 972.23 Permit # 1999, 00313 Master Remodel Permit# 1999 00260 Foundation Dear Mr. Bolen, Upon review of the layout of the hc,l;! :Uwn straps used at the above referenced location it is my opinion that they meet code requirements. Should you have any further questions please do not hesitate to contact my office Sinc Q PA��c� Jpmes Nicol!, P E. -71 Sab/hms Cc John Winters n� CITY OF T'GAR D _ _ _ MASTER PERMIT DEVELOPMENT SERVICES DATE ISS PERMIED: 3i27/0101-00037 '27 0101-00037 13125 SW Hall Blvd., Tigard, OR 97223 1503) 639-4171 SITE ADDRESS: 11590 SAN 95TH AVE PARCEL: 1S135DC-03200 SUBDIVISION: FIRDALE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: New garage. with breezeway BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT FIRST: of BASEMENT: of LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 50 SECOND: of GARAGE. 730 at FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: FINSSMENT: at RIGHT: 6 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: n 00 at VALUE: 5 16,900 00 REAR: ]9 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: GARBAGE DIST: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN<100K: BOILICMP<3HP. VENT FANS: CLOTHES DRYER: FURN>•100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVE GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP ERVC/FEEDERS BRANCH C RCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FOR: i PUMPIIRRIGATION: r PER INSPECTION: EA ADD'L 50OBF: 201 400 amp: 1 201 400 amp: lot WIO SVC/FDR: SIGNIOUT LIN LT: PEN HOUR: LIMITED ENERGY: 401 ,00 amp: 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT MANU HMISVCIFDR: 601 .000 amp: 601+amps•1000v: MINOR LAFFL: I.00+amplvolt Reconnectonb;: PLAN REVIEW SECTION +4 Rr )NITS: SVCIFDR>=225 A.: >6P9 V NOMINAL: CLS AREA/SPC OCC. !'.LECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 4TEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOMIPAGING: OUIUOOR LNDSC l.T: BURG'AR ALARM: OTH: BOILER: HVAC: LANOSCAPFARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEr%AL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS. Owner: Contractor: TOTAL FEES: $ 628.21 WINTERS.JOHN W OWNER This permit is subject to the regulations contained In the 11545 SW GREENSURG RD Tigard Municipal Code,State 4 OR Specialty Codes gr.d TIGARD,OR 97223 all other applicable laws. All work will be done in accordance with approved plans. This permit will exvire if work is not started within 180 days of issuanoe,or i'the work Is suspended for more than 180 days. ATTENTION Phone: Phone Oregon law requires you to follow rules adopted oy the Oregon Utility Notification Center Those rule`are set Re°"' forth in OAR 952-001-0010 through 952-001-JO80 You may obtain copies of these rules or direct oiesti,ns to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Framing Insp Building Final Footing Insp Shear Wall Insp Footing/Foundation Dr; Exterior Sheathing Insi Electrical Service Electrical Final Electrical Rough In Final Inspection Issued By : �; I,, rmlttes Signature : ;• I Call (301) 639-4175 by 7:00 P.M. for an Imipectlon needed the next business day Building Permit Application ("lit)' of .Tigard Datereccived: v-'0/ Permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no' Expire date: City of Tigard � Phone: (503) 639-4171 Date issued: By:,�,,,f Receipt no.: rax: (503) 598-1960 /` _ 7_ - - Case file no.: Payment type: Land use approval: . 1&2 family:simple Complex: , U 1 &2 family,.welling or accessory U Commercial/industrial U Multi-family >kNew construction U Demolition U Addition/alteralion/replacement U Tenant improvement U Fire sprinkler/alarm U Other: A fTAG r- JdR SITE INFORMATION lob address: 9�� uJ, 1rAJD ?_kAA1 7, 2Z Bldg.no.: Suite no.: Lot: Block:_ Subdivision: Tax map/tax lct/account no.: Project name: - - ) --IN i,vTt2S G�,rr.,�� .7' � R:�7GT Description and location of work on premises/special conditions: 1 1 1 Name: N W I JWVT- S Mailing address: _ I &2 family dwelling: City: State:dnE z1P: _Z3 Valuation of work..... •........... }. <a. hone: _ Fax: f mail: No.of bedroomstbaths................................. Owner's representative: Total number of floors................................. Phone: FE-m ax: ail: New dwelling area(sq.ft.) .......................... (� Garagc/carport arca(sq.ft.) ........................ 7 Y r Name: .To 14 Al W n/i R Covered Porch area(sq. ft.) ......................... _ �► Mailing address:_//S 9Lf S,w `I3 ` Deck arca(sq.ft.) ........................................ C� State: OREUI q44 Other structure arca ist, ft.)......................... t't Phone: Fax: , ,z (:-mail• ('ommercial/industrial/multi-family: 1 Valuation of work............................. Business name: r - _- [ixisting bldg.arca(sq. ft.) ............:............. Address: i l 5 9D S + •/5 �� New bldg.area(sq.ft.) ........::,,,�.,......,..... City: If J7 _ 5 tatee Number of stories s 7S ::::.: Phone:G b1.2, rax, E,-mail: Type of construction........... ................ .......6Y1 CCB no.: Occupancy group(s): Existing: City/meta IF New: Nolice:All contractors and subcontractors are required to he t ' licensed with the Oregon Construction Contractors Board under Name: e 14 Al rb � � L `L N,i ft provisions of ORS 701 and may he required to be licensed in the AC!Lm :/ yam, 5 y, 1 jurisdiction when work is being performed. If the applicant is Cit State: - 71p; exempt from licensing,the following reason applies: Contact person: Lr fr Plan no.: - Phone: rax: 1, -�� Ii-mail — --- _ lo NIT 0 amc: f E ,7 t'uutact non: f 0 w.t — f x t rs� Fees due upon application ........................... Address: - 5 T Date received: _ - --- It : State:61 - ZIP: y l z z� Amount received - Phone: W . 110E rax: E-mail: Please refer to fee schedule. hereby certify 1 have read and examined this app:ication and the Not All Jurisdictions r.cept credit cards,please call Jurisdiction for mar information attached checklist. All provisions of laws and ordinances governing this U'Ago t!ldasterCtrrd work will be complied ith,,wlietlter specified her:in or not. Credit cud number! Authorized signaturet . . = � ePrint name: Dale: Nnof cu I r nsn--l it cud — ; -- C of r 81 nature Amount Notice:This pennit application expires if a permit is not obtained within 180 days eller it has been accepted as complete. 4104613(15MMM) Electrical Permit Application — Date received: j Permit no.: 26 City of Tigard, Project/appl.no.: Expire date: City if Tiga,.d Address: 13125 SW Hr:ll Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 - Fax: (503) 598-1960 Vase file no.: Payment type: Land use approval: TYPE OF'PERMIT U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/alteration/replacuncnt U Otter: 6hif.4t& U Partial JOB SITE INFORNMION Job address: s &4/, y5 4,_LIAAa ? Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: _ " <i x"Qe _f-t3.2pc Project name:W/A(,rarj5 6,i R,+d Description and location of work on premises: Estimated date of'Corn plctionlinSpec(ion: CON I'll At-i'014 APPLICATION FEE SCHEDULE Job no: Business name: Dewriplion 011. (ca.) total it).imp �� — —-- Nen residential-single or multi-family jwl Address: 41"Ciling unit.Includes allached Ravage. City: Slelc: ZIP: Semlerincinded: Phone: Fax: G mail: 1000 sq It.to less t CCB no.: Elec.hus.lie. no: Each additional 500 sq.ft.or portiWii thereof Hinitedenergy,residential City/metro Ili:.net.: Urnited energy,non-residential _ Such manufachrrcd home or modular dwelling Signature of supervising electrician(required) _ Date Service and/or feeder Sup,elect.nnme(print). Lcensno: - Services or feeders-Inst.9Ihton, alterallon or relocation: (01-]MV 111 a 11151101011! 21111 amps or less 2 Name(print): _ t I:naps to 400 amps 2 c - -- ---- --. -_ - - ;nI snips to G00 amps 2 Mailing address: . '4 G01 snips To I(XX)amps 2 City: Slate:�1JE ZIP: 9 2- _3 Over1000ampsnrColts 2 Phone: Fax: t _ F-mail Reconnecionly Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration.or relocation: OILS 447,455.479, 0,"q l. 2M r nips or Icss 2 2111 amps to 400 amps — - — 2 Owner's sl naturi• 1 Date: A�i 401 it)600ants 2 Branch circuits-nen,alteration, Name: or extension per panel: --- A Fee for branch circuits with purchase al' Address._ service or feeder fee,each branch circuit i 2 City: State. ZIP: it Fee for branch circuits without purchase of service or feeder fee,first branch cir2 c Iuit: Phone: f,t+. F{-nmil achadditionalbranchcircuit _ PL%N HFIVHIV(Plense check all flint apply) N1 Ise.(Service or feeder not included): UService over 225amps-conuttemial UHealth carefacilm Fuchpunnp(it irrignuoncircle 2 U Service over 320 snips rating of 1&2 U Halardous location Each sign or outline lighting 2 lamilydwellings U Building over 10,000 square feet four or Signal circuit(s)or a lindted energy panel, U Sy.tem aver 6tx1 volts nominal more residential units in one structure alto..-ion,or extension" 2 U Huddle•over three stories U Feeders,400 snips or more •1 k•st n non: _ U Occupant load over 49 persons U Manufactured structures or Rv park Fisch iddillonal Inspection over the allowable In any or the above: U Egrcsx/lightingpinn U Other: Per inapection Submit sec of plans with any or the above. V Investigation fee The above are not Applicable to lemporary construction smite. Other Not rdl jurisdiciioru accept cirdit cards,piraw odl prduLcuon for more infromnnun. Notice:This permit application Permit fee..................... U Visa U MaslerVard expires if a permit I not obtainer! Plan review(at — %) $ Credit card number: f within 180 days alter it has been State surcharge(8%)....$ accepted as complete. TOTAL $ Nam of c o r as shown on c tie � - ('wdholder signature Amount 440.4M5(arWAM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below:� TYPE OF WORK INVOLVED - RESIDENTIAL ONLY _ Restricted Energy Fee.................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total I 'Residential-per unit Check Type of Work Involved: 1000 sq.ft or less _ $145 15 4 ❑ Audio and Stereo Systems Each additional 500 so it or portion thereof $33.40 1 Limited Energy $7500 ❑ Burglar Alarm Each Manufd Home or Modular Dwelling Service or Feeder $9090 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 _ 2 201 amps to 400 amos i $106.85 ❑� Vacuum Systems' 401 amps to 600 amps $16060 601 amps to 1000 amps _ $24060 2 ❑ Other Over 1000 amps or volls $454 65 Reconnect only $66.85 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system....................................... .................. $7500 200 amps or less _ $6685 _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $10030 401 amps to 600 amps $133.75_ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, — see"b"above. ❑ Audio and Stereo Systems Branch Circuits Now,alteration or extension per panel ❑ Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b)The fee fc branch circuits without purchase of service or leerier leo. ❑ Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 __ ❑ HVAC Miscellaneous Instrumentation (Service or feeder not Included) ❑ Each pump or Irrigation circle _ $53,40 Each sign or outline lighting $53.40 ❑ intercom and Paging Systems Signal circuit(s)or a lirnitad energy panel,alteration or extension $75,00_ _ ❑ Landscape Irrigation Control' Minor Labels(10) _ $125.00 Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection $62 50 Nurse Calls flet hour $6250 v--� In Plant $73 75 _ ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling r Enter $total of above fees = ❑ Other 8%State Surcharge $ _ _—Number of Systems 25%Plan Review Fee r vv"Plan Review'section on $ No licenses are required Licenses are required for all other installations front of application - -- - Fees: — -- Total Balance Due $ Enter total of above tees s ❑ Trust Account ilf 8%State Surcharge = r Total Balance Due : I 4W.%Ai•nu'CIC-ICCs due 10/09/00 o� N 89' 13'E N 89' 13' 119.005' 119.005 O �S Zi Z3 X ui od .. .. :.� ..• • /NEW GARAGE PROPOSED *�1, • ;� • .... . '•:. .•:y j :. -)NGRETE DRIVEWAY � ' • ••'� .•� ' 119:m05' 119.005' Jp/ —Ei(TG. EROS N- ��► CONTROL B (APPROVEC G.P. BUGKAL I 1� GARAGE SITE LOCATION r i LOT INFORMATION ` �•`' TAX MAP:— ----18135DG TAX LOT:— ---03?00 is ZONING: K-4.5 5uBD1vISION:-- FIRDALE r 1»� N 89' 13'E N 89' 13' 119.005' 119.005' i 7_ O U U 0 X 4-3 d) :•; '' . NEW GARAGE PROPOSED -'' ..• . '`� � / DRIVEWAY • _ -moi • 119205' 1191405' 6s •�--- EXtG. EROS ,fl c.ONTRUL 15 IAPPROVEC C.P. 5ucX AL I SITE LOCA', ION PROPOSED GARA�CsE , ._.�.. •20' L.OT INFORMAtION TAX MAP: - -15135,G TAX LOT,---- 03200 F: ZONING — -R-4.5 y SUBDIVISION:-- - FIRVALF Permit#: �1ST.y2O6/ 7 0F o � ti q� 90 Address: — :� ' o -�'_ x issued by: -''� Tate: 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 1 and 2, and either box 3A or 313: E, 1. 1 own, reside in, or will reside in the completed structure. llI \711 `'. 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 (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. l will be my own general contractor. If I hire subcontractors, l will hire only subcontractors registered with the Construction Contractors Board. If i change my mind and hire a general contractor, l 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. hereby certify that the above information is correct and that I have read and do understand the I otilrmat iml Not to Property C)w•ners about ('obstruction Responsibilities on the reverse side of this form. (Signature of permit applicant) (Date) (White cop-v to issuing agenc'� per►nit file, pink copy to(1pplicant) CITYOF TIGARC SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR1999-00154 13125 SW Hall Blvd., Tigard, OR e7223 (503) 639-4171 DATE ISSUED: 8/24/99 SITE ADDRESS; 115911 SW 95TH AVE PARCEL: 1 S135DC-03200 SUBDIVISION: FIRVALE �i� ZONING: R-4.5 BLOCK: LOT: ��-- JURISDICTION: TIG TENANT NAME: JOHN WINTERS USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWr'LLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection fee waived, prior residence demo Inspection fee dL e. Owner: - ----- FEE S WINTERS, JOHN W 11545 SW GREENBURG RD Type By Date _ Amount Receip' [CARD, OR 97223 INSP DEB 8/3/99 $35 00 99-317377 Phone: Total $35.00 — ------ Contractor: OWNLR Phone: Reg #: Required Inspections Sewer Inspection phis Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency, the permit expires 180 days from the date issued The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-198 . IsSued.py: \_y�4cll�l� _ �I(� Permittee Signature: _,A. < ' i Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next bu iness day CITY OF TIGA R D MASTER PERMIT PERMIT#: MST1999-00313 DEVELOPMENT SERVICES DATE ISSUED: 09/22/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11590 SW 05TH AVE PARCEL: 1S135DC-03200 SUBDIVISION: FIRDALF ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: Interior remodel BUILDING _ REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SE[BACKS REQUIRED CLASS OF WORK: AL'r HEIGHT: FIRST: of BASEMENT: sl LEFT SMOKE DETECTORS: v TYPE OF US^-: SF FLOOR LOAD: 40 SECOND: of GARAGE: sf FRONT PARAING SPACES TYPE OFGODST: SN DWELLING UNITS: 1 FINBSMENT: of RIGHT VALUE: S 6,000.00 OCCUPANCY G12P: RJ BDRM: 1 BATH: 1 TOTAL: of REAR PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS. LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS. 2 GARBAGE DISP: WATER HEATERS: WATER LINES. SCKFLW PREVNTR GREASE TRAPS. OTHER FIXTURES. MECHANICAL FUEL TYPES FERN<10OK: BOILICMP c 9HP: VENT FANS: 1 CLOTHES DRYER. FURN—100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTI.ETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 •200 amp: 0 700 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION. EA ADU'L 500SF: 201 400 amp: 201 •400 amp: tat W/O SVCIFDR: SIGN/OUT LIN LT: PER ROUP LIMITED ENERGY: 401 - 600 amp: 401 •600 amp: EA ADOL BR CIR: SIGNAUPANEL: IN PLANT MANU HMISVCIFOR: 601 • 1000 amp: 601+amp6•/000V: MINOR LABEL: 1000+amplvalt: PLAN REVIEW SECTION Racannecl anlV: —4 RES UNITS: SVCIFDR>•226 A.: >600 V NOMINAL: CLS AREAISPC OCC. ELECTRICAL•RESTRICTED ENERGY — A.SF RESIDENTIAL B COMMERCIAL _ AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM. INTERCOMIPAGING: OUTDOOR LNDSC LT. BURGLAR ALARM: OTH: BOILER: HVAC LANDSCAPERRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL OTHR: HVAC DATAITELE COMM: NURSE CALLS TOTAL N SYSTEMS: TOTAL FEES: $ 302.89 Owner: Contractor: 1 his permit Is subject to the regulations contained in the WINTERS,JOHN W OWNER Tigard Municipal Code,State )f OR Specialty Codes and 11545 SW GREENBURG RD SIGNED RESPONSIBILITY FORM all other applicable laws All work will be done in TIGARD,OR 97223 IN FILE accordance with approved plans This permit will expire N work is not started within 180 days of issuance,or if the work is suspendrtd for more than 180 days ATTENTION Pbal,e. Phone: Oregon law regl,ires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg N: forth in OAR 952.001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(E03)249-1987 REQUIRED INSPECTIONS Underfloor insulation Electrical Rough in Mechanical Final PLM/Underfloor Framing Insp Plumb Final ORIGINAL Mechanical Insp Low Voltage Final inspection Plumb Top Out Insulation Insp Electrical Service Electrical Final Issued By : ��__._- Permittee Signature «- Call (503) 639 4175 by 7:00 p.m. for an inspection needed the next business day UITY OF TIGARD Residential Building Permit Application Plan Check -`), `13125 SW HALL BLVD. Alteration - Interior Only Recd By_ w TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Dace Recd V 503-639-4171 Date to P E Date to DST - 2-1 y F 503-684-7297 Permit# 1N �l`1 13 Print or Type Called Incomplete or illegible applications will not be accepted Name of Project Name Job _ _ Address Site Address Architect Mailing Address .5w IS 'k+ Av T Cit /S Name • ` City/State Z_ip Phone Owner MailingAudress Name Qty/State Zip Phone Engineer Mailing Address __ CI General Name City�State Zip Phone Contractor �� Describe work New O Addition O Alteration O Repair O Mailing_Address -- to be done Prior to permit / Sir j 4 Additional Description of Work: issuance,a copy CT/State Zip y7.t23 Phone c I�e_Y%,C A e- �Q B - of all licenses � " `S4z ( .)b�J> -- V are required if OregoConst Cont.Board Exp Date PROJECT expired in COT Lic# database VALUATION_ $_ Mechanical Name — NE: ' CONSTRUCTION ONLY: Sub- Aw� S A f-,, Sq. Ft. House: TSq. Ft.Garage Contractor Mailing Address - Prior to permit Indicate the restricted energy installation by the electrical issuance,a copy Ety/State Zip Phone — subcontractor in the following areas_ of all licenses Restricted Audio/Stereo are required rf Oregon Const Cont Board Exp. Date Energy S stem Alarms expired in COT Lic# Installations Vacuum Irrigation database Plumbing Name- --_._ _..: S stem S stem (check all that Other: Sub- apply) Contractor Marling Address — Corner Lot _ YES NO Flag Lot YES NO check one) _ (check one) Prior to permit CityiState Zip Phone Has the Subdivision Plat recorded? N/A YES NO issuance, a copy of all licenses are Oregon Const Cont Board Exp.Date Solar Compliance - required if Llc.# Celcwation Attached) expired in COT I hearby acknowledge that I have read this application,that the database Plumbing Lic.# Exp. Date _. information given is correct,that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with �L__ Oregon State laws. /Name atur of Own /A en Date Electrical ��Mf Sub- Mailing Address -Intact Person Name Ph n L.,)ntractor c rL A ,r\e.r S C Y� ��,- FOR OFFICE USE ONLY: City/State Zip Phone - flat#:. Prior to permit Mapr?L#: issuance,a copy _ f i c�, I '� 10 L) of all licenses are Oregon Const.Cont.Board Exp pate Setbacks: Zone: _ Solar required if Lic# expired in COT _ Engineering Approval: Planning Approval: TIF: databa3e Electrical Lic 0 Exp.Date Electrical Supervisor Lic # Exp.Date L3 i forms%fintalt.doc(DST) 10/23/98 L 3— c,; o Datev - - -- __ ---- Statement: Information Notice to Property Owners About Construction Responsibilities Nate: ()regon Lcnv, ORS 701.055(4), requiresesructidn Conitrcst r ction tioa� to sign permit rapli- he cants w'ro are not registered with the Const required .following:stat^ment before u huildi►lg permit cuneissued.trnl�lingt pee nlitst. lSLicensed for residential building, electrical, mechanical, p architect and engineer applicants, exempt fro 1 lregistration egistill filed withdenr ORS S1n01. 010(7), need not submit this'statement. This statement vil in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. � nderstand that I mint register as a construction contractor if the structure is sold or offered for sale ❑ Iu before or upon completion. 3A. My gs-�ncrul contractor is _ --�-__._ Contractor regis. # (Name) I will instruct my general contractor that all subcontractors who work on the structure must he registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. ` hire subcontractors, 1 will hire only suhcomtrurt�rrs registered with the Construction Contractors Ii I Board. If I change my mind and hire a general contractor, i will contract with a contractor who is re istered with the CCB and will immediately notify the office issuing this building permit of the g nannc of the contractor. 1 hereby certify that the above information is correct and that 1 have`„tlreve r e side t ofthisfoInformation form. Notice to Property Owners about (,onstruction Responsihilities on - L(7- -- (Signature of permit applicant) (White c•op\ 1,, is.wning agency permit file, pink I 01)Y to applicant) / CITY C3 F T I GA R D _ BUILDING PERMIT PERMIT#: BUP 1999-00279 DEVELOPMENT SERVICES DATE ISSUED: 7/6/9 + 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S 135DC-03200 SITE ADDRESS: 11590 SW 95TH AVE SUBDIVISION: FIRDALE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: 'FIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM FIRST: sf N S: E: �W: TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: Remarks: Demolition of existing house. Sewer to be capped and inspected. All debris to be removed. I Owner: Contractor: WINTERS, JOHN W OWNER 11545 SW GREENBURG RD TIGARD, OR 97223 Phone: Phone: Reg #: � pe_ FEES REQUIRED INSPECTIONS ry By Date —Amoint Receipt Cap Sewer Line Insp _ Y PRMT BON 7/6/99 $25.00 6014 Final Inspection 5PCT BON 7/6/99 $1.25 6014 EROS BON 7/6/99 $26.00 6014 ORIGINAL ERPU BON 7/6/99 $845 6014 (additional fees not listed here) Total $69.15- — — ----- __J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for r .gyre than 180 ciay7. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. Pe nn it ee signature: --- s n'1 Issued By: � 1" L71_� (fit —__ --- ---- -- Call 639-4175 by i p.m. for an inspection the next business day CITY OF TIGARD Commercial Building Permit Application Date Recd 13125 SW HALL BLVD. New Construction and Additions Date to P.E. 'tIGARD, OR 97223 Date to DST_ i )03) 639-4171 Permit#_ Print or Type Related SWR Incomplete or illegible applications will not be accepted Called_ fName of Development/Project I Job W/N/6RS 9A0,PML=tii -- Existing Building E] New Building n Address Street Address ne //.s V Building gLg# City/State Zip Data 164 I?P" oer' 97 Z I- Existing Use of Building or Progerty: Name Property .To/I N w' W "T RS Owner Mailing Address ne Proposed Use Buildin or Property' 0 % "',' 95 City/state Zip Phone No. Of Stories: /(. 4KJ,01? 3 FrfiY" �b6 Occupant Nam.' Sq. Ft. Of Pr' ect: Name — I Occupa .y Class(es) Contractor U0,4 L) W I Nr,R S Prior to permit Mailing Address _ suite Ty e(s)of Construction issuance,a copy of all licenses are required if City/State Zip Phone Will this project have a Fim-Si p sion System? expired in C.O T (1 c Il r �/ ".?6 r�5 Yes L---- No LJ database Tyr'4 r i) $ 9 Americans with Disabilities Art(9DA) Oregon Const Cont board Llc.# Exp.Date Valuation X 25% = $ Participation Complete Accessibility orm _ Name Project $ Architect Valuation Meiling Address Suite Plans Required: See-Meftier of seta:ta-submR City/State Zip Phone / on bacK— r Engineer Name I hereby acknowledge that I have read this application,that the Information given Is correct,that I am the owner or authorized agent of the owner,and Melling Address Suite" - that plans submitted are in compliance with Oregon State Laws. Sigfratu9p of Owner/Agent Date City/State Zip Phone Contact Person Name Phone Indic-to type of work: New O Addition O Demolition f4 rc N 4) t'I, Accessory Stricture O Foundation Only O Alteration o Repair Other o -_ FOR OFFICE USE ONLY Description of work: MapfTL# Land Use ! yt s r.f + /X-e�-r`•t. 4 e')t I f < <r r lr:�1c.. n C r C Notes. Pirko: Estimated/of Employees � 11f �, , ` '- TIF: -._____--------------____-------------- -----1 If the above figure Is not suppNed at the time of application,the city will calculate the fen based upon the nuNier of parking spaces. Note: Site Work Penult Application must precede or accompany Building Permit Application IACOMNEW.DOC (DST) 5/913 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review is dependent u,�,on submittal of BOTH plans AND a COMPLETED application. For an electrical submittal, the -pplication must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner wi.1 contact the applicant to request additional plan sets for distribution purposes (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) Total—# of TYPE OF SUBMITTAL_ Plans KEY: Submitted S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) lvl = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) _ Building *BorB & M (Ali)~ *B.8CM_& P (Alt) 3 *B & M & F' & E(Alt) 3 NOl E:S "Shaded areas designate ALT submittals only. I tdstsllormslmatrxcom doc 10/30199 5EC77iON .35 •T/5 R I VV � C D SC.r1E / min = S� Tex oT 115%o S, w `75- 7 ,4c •7 ,4C T"/6-.4f?p Ofrrbo tv 97z Z 3 Y3 /3 UL r a � c i I ,. .r i 301 r t1 5. �U. 95 ° � �. CITY OF T I G A R D MASTER PERMIT PERMIT#: MST1999-00260 DEVELOPMENT SERVICESpp�TE ISSUED: 8/3/99 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 11. SITE ADDRESS: 11590 SW 95TH AVE e�\ [ �` PARCEL: 1 S135DC-03200 SUBDIVISION: FIRDALE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: pouring foundation to place a move in houae on, credit for sewer that was capped. BUILDING REISSUE. STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: IND HEIGHT FIRST. sf BASEMENTsf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD SECOND sf GARAGE- sf FRONT: 30 PARKING SPACES 2 TYPE OF CONST: 5-IIID DWELLING UNITS: FINBSMENV sf RIGHT: d5 VALUE $18 950 00 OCCUPANCY GRP: R I DORM: BATH: TOTAL. sf REAR: 53 PLUMBING SINKS: WATER CLOSETS, WASHING MACH. LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS' LAVATL RIES: DISHWASHERS: FLOOR ORAINS. SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES. MECHANICAL. FUEL TYPES i FURN<100K: BOILICMP c OHP: VENT FANS. CLOTHES DRYER. FURN>-100K: UNIT HEATERS: HOODS 01 HER UNI1'5: MAX INP: btu FLOORFURNANCES: VENTS: WOOOSTOVES. GAS OUT LETS - __ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRAVCH CIR:UITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 100 amp, 1 0 - 200 amp W/SVC CR FDR: I PUMP/IRRIGATION PER INSPECTION. EA ADD'L 5005r: 201 400 amp: 201 -400 amp' 1sl WIO SVCIFDR: 00 SIGNIOUT LIN LT. PER HOUR. LIMITED ENERGY: 401 600 amp: 401 600 ar o. EA ADDL BR CIR: SIGNALIPANFL. IN PLANT: MANU HMISVCIFUR: 601 • 1000 amp, 601-amps-11000v MINOR LABEL. 1000-amp/volt PLAN REVIEW SECTION Reconnect only —4 RES UNITS: SVCIFDR-225 A.: 600 V NOMINAL CLS AREAISPC OCC _ELECTRICAL•RESTRICTED ENERGY A.Sr RESIDENTIAL _ B.COMMERCIAL. AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING. OUT LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC. LANDSCAPEIIRRIG, PROTECTIVE SIGNL. GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL+ OTHR: HVAC DATA/TELE COMM: NURSE CALLS. TOTAL x SYSTEMS. Owner: Contractor: TOTAL FEES: $ 792.41 This permit Is subject to the regulations contained in the WINTERS,JOHN W RIVERSIDE HOMES Tigard Municipal Code.State of OR Specialty Codes and 1 1545 SW GRE ENBURG RD 15455 NW GREENBRIER PKWY all other applicable laws All work will be done In T 1(;ARD,OR 97223 #140 accordance with approved plans This permit will expire rl BEAVERTON,OR 97006 work is not started within 180 days of issuance,or if the work Is suspended for more than 180 days ATTENTION Phon: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg M. forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion 844 8444 Crawl Drain/Backwater Electrical Final Sewer Inspection Electrical Service Plumb Final Footing Insp Rain drain Insp Final inspection Foundation Insp Water Une Insp Underfl9 trT9TTtMten ApprlSdwlk Insp t Iss ed By : —P, Ck) L Y _ Permittee Signature : Call (503) 39-4175 by 7:00 p.m. for an inspection needed the next business day Permit #: 1`"`C � 9 ! � 0 �� 5 f'fJ F Address: 1 1 5 9 — - - . „;o '^ Is Cd6r. Date: - 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 sta►ement 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 befiled with lite permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 38: ✓ 1. 1 own, reside in, or will reside in the completed structure. 2. I understand that 1 must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is ---—--—— F-1 ('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 I will he 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. 1 hereby certify that the above information is correct and that I hay c read and do understand the Information Notice tc 'roperty Owners about construction Responsibilities on the reverse side of this form. �c -- /97. — __________ _ 3, it applicant) �- (Date)d �� (Signature of perm (White cope to issuing agene Y permit file, pink copy to,applicant) 7c. ►F TIGARD Residential Building Permit Application Plan Che_ ;�Z66R Recd LLfi'r 13125 3W HAiuL BLVD. Additions or Alterations ey Date Recd TI%-IAFcD,'OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. V503-639-4171 Date to DST '7-2 7' y F 503-684-7297 Permit# j�1> /f y-o a 2 L U Print or Type Called__ Incomplete or illegible applications will not be accepted o/sy Name of Project Name r Job Mailing Address Site Address — ��— Architect Address _ _ � I ip `J-��" V �1 G -cA City/State ZipPhone_ Name o` �____r' 5 Name Owner Mailing Address [r r.r,,.,r *,\ Mailing E 2 hl 13c 5W S_1 Engineer MailingfAddress C State Zlp Phone f D r, Z 0 c G (aS City/State Zip Phone General Name F. 'j._, :' ' , . I H'-o-,r>,, Contractor Describe work New O Addihon O Alteration O Repair O Mailing Address to be done: _ Prior to permit Additional Description of Work: issuance,a copy City/State Zip Phone MTO P12o a-ry of all licenses __ are required if Oregon Const Cont.Board Exp Date PROJECT expired in COT Lic.# VALUATION $ 4' database ---- I Mechanical Name — — NEW CONSTRUCTION ONLY: Sub- Sq Ft. House: - Sq. Ft. Garage ND Contractor Mailing Address — r . Indicate the restricted energy installation by the electrical Prior to permit — subcontractor in the followi rg areas issuance,a copy City/State Zip Phone Restricted Audio/Stereo of all licenses _ are required if Oregon Const.Cont.Board Exp.Date Energy ' i/A _§X-,Le rn } Alarms expired in COT Lic# Installations Vacuumr' ! Irrigation /A S m da.abase -System S ste Plumbing Name (check all that Other: Sub- f , r a I _ Contractor Mailing Address e Corner Lot YES NO Flag Lot YES NO _c eck one) (check one __ Has the Subdivision Plat recorded? N/A YES NO Prior to permit City/Stele Zip _ Phone r issuance,a copy _ of all licenses are Oregon Const Cont Board Exp Date required if Lic.# I hearby acknowledge:that I have read this application,that the expired In COT database Plumbing Lic.# Exp. Date information given is correct,that I am the owner or authorized agent of the owner,and that pians submitted are in compliance with _ Oregon State laws, Name _ at re of Ow / e Date Electrical bri act Person Name Phone# Sub- Mailing Address Contractor City/Slate Zip Phone Prior to permit issuance,a copy FOR OFFICE USE ONLY: _ of all licenses are Oregon Const Cont.Board Exp Date Plat#: MaplTL#. required If Lic.# expired in COT database Electrical Lic.# Exp.Date Setbacks: Zone: Solar: Electrical Supervisor Lic.# Exp.Date Engineering Approval: Planning Approval: TIF: I\dsts\forms\sfaddalt doc 11120/98