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CITY OF TICARD F_,wLb1w4 SEPI . Cory—
ENGI
DEVELOPMENT SERVICES PERMINEERINT GPERMITEN698-0008
13125 SW Hall Blvd.,Tkoard,OR 97223 (503)6394171 PRIM. PERMIT' ENC398-0008
DATE ISSUED: 03/J7/98
:-.)ITE ADDRESS. . . c 13620 SW 115TH AVE' F,ARCEL_s 2S1030C05300
SUBDIVISION. . . . a VIEWMOUNT ZONING.-R-4. 5
BLOCK. . . . . . . . . . : L-04. . . . . . . . . . . . . ..041 JURISDICTION: TIG
-------------------------------------------
PErIT TYPE. . .- SOP PUBLIC 1MPRV a GIUANT. (L" N FT) VALUE
AGREEMENT DATE: / / BRAD/EROS $
ASSURANCE EXPIRATION--- STREET $
PEPFCRMANCEa SAN SEW
MAINTENANCE: SIM SEW
PATHWAYS
ALL OTHER $
TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Hem air kss STREET OPENING, 10 REMOVE AND REPLACE DEFECTIVE CONCRETE
SIDEWALK/APRON.
Perm itt:,:ei FFES
JAFLO CONCRETE type amount by date recpt
P. O. BOX 546. OPEN $ 26. R0 JSD 03/06/98 98-303886
NEWBERG OR 9*7132 BOND $ 670. 00 JSD 03/06/98 98-303686
Phone #t 554--9055
Engineer:
696. 80 TOTAL.
#
REQUIRED INSPECTIONS -----
Permittee/Agee signaiti.irep - ----sTORN SEWER---- .-----STREET-----
F
.1. H. & C. B. CRS LIN[: A GRADE
PIPE L14 & GRD SUBGRADE
Issued B BCKFLL & CMPCT BASE' RUCK
(I JQ, (VAe11L_A_1L------------ ATR & TV TEST LEVEL- COURSE
Vity of Tigard, nr-egon WEARING COURSE
13125 q. W. Hall Blvd. ----SAN. SEWER--- TRAFF & PED CONT
TIGARD, Orpgon 97223 M. H. A C. O. MONUMENT14TION
V) Phone #s 639-417t PIPE LN & GRD STREETLIBHTING
BCKFLL & CMPCT WALK/APRON/RAMP
PIR & TV TEST
FOR INSPECTICIN, CONTAC1 ---ORAD I Nt3——
w Loths Thoma, #639-4171 (office) --RFPRI S/ADJj S CONTOURS
4780-R647 !.00bile) DRAINAGE
----PATHWAYS—- EROSION CNTL.
SPECIAL CONDItIONSP
=A
LkCITY O F T I G A R D MECHANICAL
DEVELOPMENT SERVICES PERMIT
Malum 13125 SW HOY Blvd., Tigard,OR 97223 (503)6394PERMIT #. . . . . . . : MEC97-004,4171 DATE ISSUED: 02/28/97
PARCEL- 2SI03DC-05300
SITE ADDRESS. . . : 13820 SW 115TH AVE
SUBDIVIS-ION. . . . : VIEWMOUNT ZONING: R-4. 5
PLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :41
------------------------------------------- -
CLASS OF WORK. . :ALT FLOOR F tJ R 1\1. . . . : 0 EVHP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :P3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . . 0 DOME7). INCIN: 0
- /GAS/ 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR '.!NITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50-4- HP. . . . - 0 CLO DRYERS. . ; 0
NO. OF UNITS------------ AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 10011 BTU: 1 10000 cfm : 0 GAS OUTLETS. : 1.
FURN ) =iOOK BTU: 0 10000 cfm: 0
Rent,4-Ks : Install freestanding gas stove
Owner. ------------------------------------------------------ FEES
T' 11 DOUGLAS & M P DOUGLAS) type amount by date reept
1.1820 SW 115TH AVE PRMT $ 225, 00 .TSD 02/ .8/S'7 97-291030
5PCT $ 1. 25 -TSD 02/213/97 97-291030
TTGARD OR 97223
Phone #: 639-2482
Contractor:
LUDEMANS INC
1.;-675 SW BEAVIIRDAM RD
BFAVERTON OR 97003 ---._--------------.___—_--._—___--_—_.—_
Phone #: 646-6409 $ 26. 25 TOTAL
Rt-g #. . : 000514 ------- REDUIRED INSPECTIONS
This permit is issued subject to the "FgUldtions contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes W all other Final Inspection ...............
applicable laws, All work will be done in accordance with
3pproved plans. Tnis permit will expire ir work is not started
within IN days of issuance, or if work is suspended for more
thar, 181 days.
CL
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mTssl-ted 13:;
UJ Call for inspection 639-4175
02/28/97 Ob.44 $503 884 7297 CITY OF TIGARD riani.ntrxs X1002/002
CITY OF TIGARD Mechanical Permit Application6 - -
13125 SW HALL BLVD. Cornmercial and Reside;itial DerteRec'd 'n
TIGARD, OR 97223 Data to P.E.
nate to DST_
(5d3) 639-4171, x344
Print or
Permit#/1fCc-r)i� Cra�
TypePermit
Incomplete or illegible a plications will not be accepted _
Nerve of DwekpmertlrPrapa Description
045 5 m✓a I Ns r4 -4-T1 0� Table IA Machanit al Code Qtr PRICE APRT
Job Street Adetm Sultoo A) Permit Fee -0- 10.00
Address a-_,. 6,--zo r,, --
Oklo CrryiBrrfe p B) Supalernantal Pemlit 3.00
mann(of nWMui brwnes:) 1,) FumvA to 100,OOt S rU / e 00
Dwner e NI- M P D L)U U t-A 3 incl,duets b vents
li cij Adrkess 2.) rurnoue 100,000 BTL'+ 7.50
At
incl,lugs 5 vents
GrtyrBun zip PnOne 3,) I Of r Ufn9rA _ e.
a(L 639 -�1?L Incl.vent
-- - _ -
Nama fa Warne ct busswssl 4,) ,uapF.i tar,oval heater 8.00
k Or tl�or mounted heater -
OCCupilIt sneai^9 aueroee 5.) Vent not ina in
appliance pe tin
ciryietre 6) Boiler or armp,heet pump,air Gond, 6.00
to 3 HP.abso,p unit to 100K BTU
Gontrwax Nerne 7.) Boiler or nnmp,heat,P,-V,air card- 11.00
(Prior to � J D E-a 16-1 5 _3-15 HP;abeorp unit to WOK BTU
Issuance iuiiiimil Wean.e----. - !!j Boller or corN.,heat pump,air oo
appli-rant I 4, 5 5 •�) � e v4 r l U n 15-30 HP,ebn_or�l unit.31 mil E1T11
must provide all C1111Surte -Y. Plions 9) Boinr or::camp haat pump,air rand. - 22 51
etx+trarinr c A f�T, T CV r-.l `T},�OS byb �`t� _30.50 tit.ahao unit 1-1.78 inti 9111
license Oregon Curio Can.Bold Liul Eqo.care 10) Boiler x comp,heat pump,air tend- 37,50
information >511 MP;shsnrn unit 1 75 m1 FM1
fur COT -G-"UFOTex Or raetroa 11 ) Air handling unit to 4.50
detebas') 10,(W CFM
ArchRect Nen'" 12) Alf handling unit 7.50
r J //� _ 10,000 CTM r _
Or McllhgAd refs —_ 13.) Non port2WQ —�^ 4�
evqporate cooler
Engineer � — Zip Phmo 14) Vent fan connected - -- 3.00
r roe shale duut
13escntx work New U Addition O Alteration 0 Repair O 15.) Ventilation system riot 450
to be done Residential O Non-residential U nducted in appliance permit
Additional DesC"nn of"It 11 R) Hou:served try mechaniad exhaust 450
17)�0tmle0c Y1Gnerator5 —I ---
Ercisling use ofI 18) Commercial or mdustrialtype 30.00
hurlding or property__PV-i V 4 I-I K0S i �1 2✓1'- _ incinerator A T_- _----
1 .) ep?�;mils ---•- 4.50
Pmpoar_d use of 201 WtKKlctove 4.50
hulkling or property N r� C 11„A-N G-C
Clethee dryer,etc 450
Type of hAii-ell—on pasha LPG O elscttic S' a unity 450
I hereby ge that I have read this application that the 73) sas piping one do four outlets r 2.00
information given i5 conr?ct,that I am the oume'or authorhied agent of -_
the.owner.that I,lens submitted are In 001'rVllanes with Orogen 61111-ft24) Mere then 4 per o0ot (each) S()
rt beaus
Signalum of OwradAgwtt U Date OTV.SUBT A-
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Cottt a PeReon Name Phone —�BURG ARGE r
VAN RE\IEW 25%OF SUSTCTAL
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i:ldat+rnechpmidoa (rev 7 "A�nhN1m Pam*Iia ie S25.5%su"arg iff
CITY OF TIGARD BUILDING I SPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing R-Aln Drain Cover/Service FIN
Foundation Water Line Ceiling l-Plumb
Post/Beam Mach. Shear/Sheath Framing -Mech�)
Plbg.Und/Fir/Slab Plbc,.Top Out Insulation -Elect.
Post/Bearn Struct, Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk ein
Other:
Date:-��--E�-- C'%'��- P . Entry:
Address: �—s—�—�' 1 4 —
_. Ste: _ MST:
Tenant:
BOP:
Con/Own: _ MEC. r
— C) PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: -.-
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Inspector _ Date:
�_APPROVED DISAPPROVED/CALL FOR RE.,ISP. CF CO
CITY OF TIGARU 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 Mach
Plbg.Und/Flr/Slab Plbg. lop Out Insulation -Elect.
Post/Beam Struct. ec . ough-In Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: 3 ke A.M. �I P.M. L-ntrYi: _
Address: -3_ Z..y ,[�, ,"%-~ �—
Tenant:._ Ste:-- MST: _
BLIP:
Con/12p: �b•� MEC:
THE FOLLOWING CORRECTIONS ARL REQUIRED: ELR
C.,cl.y,� •�..irr A,11c�� i.,. G:1,4c.��
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Inspector: Date:
_APPROVED __DISAPPROVED/CALLFO13 RRSP.— CF CO
CITY OF TIGARD BUILDIN i INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business P.Sone: 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. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain ramin -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall / Gyp. Bd. -Elect.
Date Req /uested: 1 ! 1 Time: AM PM
rrwy�cA77ddrJesss: / I .3 � Z
`$ u -1 �Q- Z� Permit q:W S 34 1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: ^'"-'"—' Date:
_APPROVED DISAPPROVED APPROVED SUB JE(' TO ABOVE
Call For Reinsp.
CITY GF TIGARD MASTER PERMIT
PERMIT" i. . . . . . . : MST95--0367
COMMUNITY DEVEL.OPMENT DEPA�rir, -..NT DATE ISSUED: 09/28/95
13125 SW Hall Blvd.Tigard.Oregon 9'72?3.8191 "(503)839=417' / 7 7 7
PARCEL.: 4:_3 1 03DC•_.171w.•3012)
SITI:� ADDRE-5S. . . . 13.820 SW 11.5TH AVE-
SUBDIVISION. . . . : VIEWMOUNT ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 41
BUILDING ------
RI:I SSUL:. DWELLING U!J I TS:0 BASEMENT. . . . . . . . :0 s f
CLF,SS OF WORK. :ALT ..AEDRMS:O BATHS:O GARAGE. . . . . . . . . . :0 sf
TYPE t]F USE. . . :SF FLOOR FEQUIRED 7�c—�TBACKS------------
T YPE OF' CONST. :5N F I RST•. . . . :0 s f LEFT. . :0 f� R I GHT. :0 ft
OCCUPANCY GRP. :R3 SECOND. . . :0 s f FRONT. :121 ft RF_AR. . :0 If,I
STr'R I ES. . . . . . . :0 F 1 NBSMENT:0 s f RECU I FRED---------------------
HEIGHT. . . . . . . . .
—_-- _.-._--_—_____HEIGHT. . . . . . . . : 0 ft sf SMOKE DETECTORS. :
FLOOR LOAD. . . . :0 psf VALUE. . . . . $ 400 PARKING SF'4CES. . :0
Remarl�s : CHANGING WINDOW INTO A DOOR
PLUMBING
SINKS. . . . . . . . . . .0 FLOOR DRAINS. . . . :0 BACKFLOW PRE'VNTRS. . :0
LAVATORIES. . . . . :0 WATER HEATERS. . . :k71 TRAPS. . . . . . . . . . . . . . :171
TUB/SHOWERS. . . . :0 L...AUNDRY TRAYS. . . -.0 CATCH SASINS. . . . . . . :0
WATER CLOSET5. . :0 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATF_R LINE (ft ) . -0 OTHER FIXTURES. . . . . .0
Gr)RBAGE DISF'. . . :0 RAIN DFRAIN (ft ) . :0
WASHING MACH. . . :0 SF RAIN DRAINS. . :0
MECHANICAL. ---- -----____.._.___..______._._.____.____ FEES —.___._____.___.___
FUEL. TYPES----_._._.__-__. UNIT HTR5. . :0 type am01_Int by date recpt
VEN-S . . . . . :0 BPRT $ 25. 00 B 09/28/95 95--271073
MAX INPUT:O BTU VENT FANS. . :111 BPLC $ 16. 23 JD 09/.16/95 95-1='70')8.1
►=URN ( 100K . . :0 HOODS. . . . . . :0 BSPC E 1. 25 B 09/28/95 95-271077
F"URN ) =1.00K . . :0 WOODSTOVES. :0
FLOOR FURN. . . . :0 CLO DRYERS. : 0
BJII_/ClhF' ( 31-i :0 OTHER UNITS:O
GAS OUTLETS:O
Owner:
BRIAN DOUGLAS
1381'0 SW 115TH AVE
T19ARD OR 97223
I--'hone #: 639-2482
Contractor:
OWNER
Phone #:
CL Reg #. . : 00171000
f 42. 50 TOTAL
This permit is issued subject to the regulations contained in the -- --- -- REQUIRED INSPECTIONS --- -- 1
Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing I n s p
applicable laws. All work will be done in accon'ance with approved I n sk.r1 a t i o n I n S..p ! _
plans. This permit will expire if work is not star within III Gyp Board I n s p
days of issuance, or if work is suspended mare h lee days. Pl..t i Id i n g Final
er•mittee C> 1W at-Ure : _ --
T s s 1_I e ri By
Cal l for inspect ior1 — 639-4175
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NAME a DULL A-10;, BRIAN 1-4 (Al'Al HMLJU141' a 0. IAIA
HDDRI-S�-, a 103,3i SW VIEW 09 e B 9S
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PURPOSI- CO IU I AMOUNI PAID PURPOSE OF tl(-iymtr4( HMUUN I P$:l 11)
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Residential Building.Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: i 3�16 SSW I rstt, AV
Subdivision: Lot # — _ Office Use Only
Valuation:
40 C) y0 Contact Date / / Initials
Result
New Construction Only: (Square Footage) Planck/Rec # �;
Permit # !4
House: _ Garage:
Reissue of
Map ... TL # .;15( 03 0(-" -05.3e-)
Corner Lot? Y N Flag Lot? Y N Zone _
Owner: t3ft r A nJ $ MAfL �O U Plat #
address: %3t 20 S W 11 5'w A U ALprovals Required
'TI Ci AYL 0 6& cf 7 2 ?-,I Planning Setbacks —_ Solar
Engineering _
Phone 3C"( 2 t-} Z-`_ Other
ow Items Required
Contractor:
Address: Subcontractors -
-- Truss Details
Other
Notes
Phone:
Contrac'or's License
(,�tta(,;i copy of current Oregon license)
Contact Name: — - -
C-)ntact Phone ) _
Subcontractors: Architect/Engineer:
Plumbing: Al�? _ Address: —
n.
�1 Mechanical:
n
(attach copy of current OR Contractors License)
y Phone: �— )
-� JOB DESC YTI 044,,J q c %'X (S7 W Cj K/A186 KJ -7b P441`10
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Is�3, 635 X Z
-' Aooli Sign Applicait Phone
76 Received by Date RG.,oivcd 7 G 7
Permit 9 Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) S ��_j,�:ra
Plumb. Permit (PLUMB) _
Mech. Permit (MECH)
State Tax (TAX) Z f � '
�r
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) �, 1_ )� ,C�
� 1v
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) _
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
a -
Water Quantity (WQUANT)
> Fire Life Safety (FLS)
rasion Cntrl Permit (ERPRMT)
w Erasion Planc'./USA (ERPLAN)
J
Erosion PlanckfCCT (EROSN)
TOTALS:
Permit #:
\� Address: 1�$7-O �.�1-c� �S .�►Il .
Issued by: 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 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:
i. I own, reside in,or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
r 1 3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work un the structure must be
registered with the Construction Contractors Board.
OR
® 3B. 1 will be my mown general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
a 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 immediat(;ly notify the office issuing this building permit of the
N name of the contractor.
T
I hereby certify that the above information is correct and that I have read find do understand the Infortnalion
Notice to Propertyt e - a out Construction Responsibilities on the reverse side of this form.
w
- - -S �et � 1995
(Signat re of f)ermit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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