14958 SW 109TH AVENUE ' n «
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BUILDING PERMIT
PERM
CITY 1OF TIGARD Df�TEI ISSUED: . 011/27/96r_LJP96---00 ,
COMMUNIT"i DEVELOPMENT DEPARTMENT
13125 SW Ht;i 8'vd.Tigard,Oregon 97223*8199 (503)639.4171 PARCIZL: r2c.3110AA 9 e�b 6 0
SUBL)I%,JISION. . . . : CANTERBBURY WOODS CONDOMINIUM ZONING:R- 12
FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :60
FIE:I SSUE: EXTERIOR WALL CON5TRUCTIOINI
71-nSS OF WORK. :REP FIRS'. . . . . 0 5 N: E. W.-
i-,E OF USE. 117 SECOND. . . S f PROTErT OPEN I
TYPE Cj.: CONST. .5N
0 Sf N: S: E- W:
OCCUPONCY GRI--,. :R3 0 s ROOF CONST. f7IRE RET , :
OCCUrIANCY LOAD; 0 BASEMENT. : 0 5f AREA SLP. RATED:
S. Tl Q. . 2 HT. 0 f t GARAGE. . . : 0 s OCCLJ SEP. RATED
L35MT'7 i ME_Z Z?. REOD SETBACKS-----
FLOOR LO(.)D. . . . : 0 psf I-EF**T. 0 fi RGI iT : 0 t F=IR SPKL: SMOK DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft F'iR ALRM: HNDTCP ACC:
BEQRII`3-, 0 BATHS : 0 IIYIP ;SURFACE: 0 [''RO CC. RR: PAPKINE. : 0
VALUE. $ -. 21700
Remarks : Repair due to storm damage. N7, fee esse-,St.,U. Concis roof.
Owner: rEES
JAMES OURY AND HELEN type amount by date recpt
14958 SW 109TH PRIAT $ 0. 00 JSD 02/1-5/96 STORM
TICARD OR 97224
Phone fi : 6L'_.'0-6901'
(Lantractor:
HORIZON RESTURATICJN�,
16176 SW 72ND AVENUE
TIGARD OR 97224
Phone #g 503-6,20--.2L-;A113 $ 0. 00 TOTAL
Req #. . : 46081
REWIRED INSP1(*.'.CT IONS
This pervit is issued subject to the regulations contained in the F:_rantinq In-,:-)
Tigard Municipal Code, State of Ire. Specialty Codes and all other Final Inspecl: iun
applicable laws. All mark will be crone in accordance �.ith
approved plans. This pernit will expire if work is not started
sithin IU asys of issuance, or if work is suspended for sere
than 180 days.
4
.Lttee �j it
BY -
Call fut ttipv,Aian 639-4. 75
Cityr, _ -Commarcial Eui ` yPermit Appl IGat;.
on
of Tig&d
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 539-4171
Jobsite Address: � �
(A) Cl'
Tenant: _ Suite #
Offir..e Use Only
Valuation:
Planck/Rec #
C� ---
Permit#
Owner: -jiL�Y�S �� 1 Map & TI_ #14 q
Approvals Required
-- q7zz __6 1,4
L L Planning r'`r,
Phone: lb Z e) �- 6.6 _ Engineenng
Other
Contractor: f I
Address: 16(7� C',) w
ov ` Type of const: _
___L.L�
gAd q-122,
Phone: low -zzt5
r _ Occupancy class:
Sorinklered? Yes No
Contractor's License # _
(attach copy of current Oregon license) Sq. ft. of project: .
Ccntact name R phone: -L> > r F(-Vll U - Story (1st 2nd, etc.) _
Proposed use:
Archi'ect/Eng!neer:
Previous use
Address: _
y Note. Plumbing R mechanical plans
v _ must be submitted at time of
building permit application.
�- Phone:
m
JOB DESCRIPTION: `�1�1���5 rwa"A' �� ,' n,¢ f �l �' ~ t uqL(Z ifV—
J
I' -
Applicant Signature & Pone number
Received by: _ �— __ Date Received: '
Permit M Account Descriptlon Amount Amt. Pd. Bal. Duel
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK.)
13ldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dew Charge (PKSDC)
Residential TIF (TIF-R) _
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-Il
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
rt
Water Quantity (WQUANT)
y
F-
Fire Life Safety (FLS) /
°? Erosion Cntrl Permit (ERPRMT)
-� Erosior '-1Ianck/USA (ERPLAN) .
Erosion Planck/CO (EROSN) /
TO''ALS:
CITY OF TIG'`.RD BUILDING INSPECTION NOTICE
Inspecti-m Line. 639-4175 Business Phone: 639-41",'1
Footing Rain Drain Cover/Service 1-li'AL:
Foundation Water Line Geiiing -Piomb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas LineAppr/Sdwlk Reins.
C, (I
Other-
Date _ A.M. - P.M. Entry:
Address: (, 't`4
Tenant: - __ — Ste: U�
Con/Own: _ __ IV(�C: —�
PLM:
ELC:
THE FOLLOWING CORREOTIONS A REQUIRED: ELR: _
N _
J
C,
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Inspector: __. _ Date/7
i 'APPROVED
—DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD WALDING INSPECT!nN NOTICE
Insoection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Riugh-in FINAL:
Post/Beam Mech. San Sewer Gas Line -Bldg.
Plbg. Underf'oor Rai,) Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Undertlr. Insul. Snear Wall Gyp. Bd. -Elect.
Date Requested.— t '� Time P.M FM
Address:
Builder: Permit #:
,AE FOLLOWING CORRECTIONS ARE REQUIRED:
CIO
F- -
lnspector:_ — - 1, _ Date: , S
2�` ��
_APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
eT\ v V _Call For Reinsp.
I
City of Tigard, Oregon
Detailed Damage Assessment Form
BtIILDING DESCRIPTION:
OVERALL RATING: (Check one)
INSPECTED(Green)
Name: __ LIMITED ENTRY (Yellow)
UNSAVE (Red) ❑
Address: 1y°�`�rti 5w 100. — --
DATE \ '�� lTIME 3' `-1 am
'S
No.of Stories:
Basement: Yes ❑ N�h ❑ Unknown O
Approximate Age.
° years REPORTED BY —
Approximate Area: square feet Ir, ,PECTION TEAM MEMBERS
Structural System: --
Wood Frame ❑ Unreinforced mason •y ❑ -- —
Reinforced M 3sonry ❑ Ti.i-tip ❑
Concrete Fran,e Q Concrete Shear Wail .J
Steel Frame U Other _ —
Primary Occupancy d
Dwellings:Other Residential U Commercial ❑ Notified occupants to vacate
premises ❑
Office ❑ Industria U Public Assembly ❑ Occ,ipants indicate temporary housing
School ❑ Government FJ Emer.Serv. U is required U
Hospital U C'ther --
Instructions: Complete building evaluation and checklist on next page and then surr marize results below.
Posting Existing Recommended — ---
None U Posted at this Assessment:
Inspected%Green) U ❑ ❑ Yes X-Y—No
Limited F ntry(Yellow) ❑ U Existing posting by:
Unsafe(Red) C U —
Area Unsafe ❑ U ----
Recommendations:
> O No further action required
U Engineering Evaluation required (circle one) Structural Geotechnical Other _
J Barricades neede(i in the following areas: _--—_
❑ Other(falling!woad remorml,shoringlbracing required,etc.): — ---
Comments(Why posted Unsafe,etc.):
Sheet of