12195 SW 116TH AVENUE i
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CITY OF TIGARD BUILDING INSPECTION DIVISION oms
24-Hour Inspection line: 6'39-4175 -. Line: 639-4171 BUP
i
_Date Requested__ \' AM_ PM BLD
Location
Imo- I CI C _ I I .� Suite MEC
Contact Person Ph - _ PLM
CoritzfAgr Ph SWR
ILLD ING Tenan'JOwner ELC
Retaining Wali _ !L.R _
Footing Access:
Fcjndation �� / '� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: r c C/ I 7 �� --- — -
Slab �- SIT
Post&Beam
Ext Sheath/Shear -.-
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling
Roof
ART FAIL - --- - - -
MBIN
Post&Beam --
Under Slab _Top Out -
Water Service
Sanitary Sewer
Rain Drains ----_-_� ___-_-_--__---_ -
RT FAIL
MECHANIC_AL)
Post& Beam
Rough
_..__._�------- -- -- - --- -- -
Rough In
Gas Line --------- -e- - - -_ --Smoke Dampers
Dampers
Cin
S PART FAIL
Service --- - _--- ------- - - ----
Rough In
UG/Slab _-.--- --_.____--------_._----- -
Low Voltage
V1 Fire Alarm
F al
PART FAILSITE—
__-_ ---- -- -
J
Backfill/Grading -- --
w Sanitary Sewer
'j Rains ection fee of$ required before next inspection, Pa at Cit Hall, 13125 SW Hall Blvd
Storm Drain ( I p --- 4 p y y
Catch Basin
Fire Supply Line ( J Please call for reinspection RE _ -_,-- - _ [ ]Unable to inspect- no access
ADA ------
Approach/Sidewalk
---~Approach/Sidewalk Date Inspector D Ext
Other T - +-
Final
PASS P, RT FAIL DO NOT REMOVE this inspection record from the job site.
Y
CITY O F T I G�►R® MASTER PERMIT
PERMIT#: M3T1999-00288
rt DEVELOPMENT SERVICES DATE ISSUED: 8/27/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12195 SW 116TH AVE PARCEL: 2S103BA-00132
SUBDIVISION: LERON HEIGHTS NO. 2 ZONING: i,. 4.5
BLOCK: LOT:022 JURISDICTION: TIG
REMARKS: Addition of a 39 square foot new entry, covered patio and ca,port to an existing single family.
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 16 FIRST: 39 sf BASEMENT: sf LEFT: 11 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECONDsf GARAGE: 240 sf FRUNT: 36 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT:
VALUE: $55,000 OP
OCCUPANCY GRP: R3 BDRM: BATH: I TOTAL: all REAR: 03
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: 1 LAUNDRi 1kAYF: 1 RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 1 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES TURN<100": BOILICMP<OHP: VENT FANS: 2 CLOTHES DRYER: 1
GAS FURN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL'UNIT _ SERVICE FEEDER__ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS 0 200 amp: 1 0 200 amp: WISVC OR FOR: i PUMPILRRICATION. PER INSPECTION:
EA AOD'L 500SF: 201 400 amp: 201 -400 amp: 1st W/O SVC/FDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNALIPANEL: IN PLANT:
MANU HM/SVC/FDR: 601 - 1000 amp: 601+amps•1000v: MINOR LABEL:
1000•amp/volt
PLAN REVIEW SECTION
Raconnect only:
>=4 RES UNITS: SVCIFDP>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCG
ELECTRICAL-RESTRICTED ENERGY
A.S'."RESIDENTIAL B.COMMERCIAL_
AUDIO R STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOWPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM. OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHW
HVAC: DATA/TELE COMM: 14URSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL. FEES: $ 1,068.98
This permit is subject to the regulations contained in the
MORRISON, TERRY A SANDRA JTC INC Tigard Municipal Code,State of OR Specialty Codes and
12195 SW 116TH 3324 SE 57TH AVE all other applicable laws All work will be done in
TIGARD,OR 97223 PORI!AND,OR 97206 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance,or if the
work is suspenJed for more than 180 days ATTENTION
Phone: Phone: Oregon law regUires you to follow rules adopted Ly the
a Oregon Utility N3tlfication Center. Those rules are set
Pogo: LIc 51x66 forth in OAR 9a2-001-0010 through 952-001-0080. You
N may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987,
REQUIRED INSPECTIONS
►� Fooling Insp PL.M/Underfloor Framing Insp Mechanical Final —
Foundation Insp Mechanical Insp Shear Wall Insp Plumb Final ORIGINAL
W Po:,t/Beam Structural Plumb Top Out Insulation Insp Final inspection
—1 Post/Beam MechanicalElectrical Service Rain drain Insp
Underfloor Insulation Electrical Rough In Electrical Final
Issued [iy � �, i� "1 Permittee Signature
Cail (503) 65114175 by 1:00 p.m. for an inspection needed next business day
OF TIGARD Residential Building Permit Application Planch
13125 SW HALL BLVD. Additions or Alterations Recd B
Date Recd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.
V 503-639-4171 Date to DST F''2
F 503-684-7297 Permit# M` 9-ooagg
Prin' or Type Called_ s?,/S
Incomplete or illegible apt lications will not be accepted
1/m
Name of Project ` Name t-1 / �I
Job I'et'1' AL''�' t5�1=- qr, Mailini Address l�
Address Site Address. `'U e4 SL
Z( �S-L / �� �>L' '�t' F' • C' /S a Zip Phone
RN�
Name +1;L-4 �Z
Owner Mailing Addr Name
�►" �lz
City/sta' Zi P cine Engineer Mailing Address
f U'A l�� 7�Z -' s I c
City/ tate I Zip Phone
General N me A- "" . e j 71! 7.Jv d`-76
Contractor �J r L t C Describe work New O AdditionA Alteration O Repair O
Mailing Address --- to be done:
Prior to permit �S ) �f'Avt- _ Additional Description of Work: � - /1.� I
issuance,a copy y/ to Zip Phooe /-f
of all licenses a."#Tt 24 c(7-?,(-,.. 77 1-'T C
are required if Oregon Const.Cont.Board Exp.Date PROJECT 00
expired in COT Lic.# 5-K-fl �i- �/ n� VALUATION $ ��C
datibase t-�
dal�
Mechanical Name — NEW CONSTRUCTION ONLY:
Sub_ Sq. Ft. House: 3q Sq. Ft. Gage
Mallin Address 1 �
Contractor s
Prior to permit Indicate the restricted energy installation by the electrical
issuance,a copy City/State Zip Phone subcontractor in the following areas
of all licenses Restricted Audio/Stereo
are required if Oregon Const.Cont Board Exp.Date Energy System Alarms
expired in COT Lic# Installations Vacuum Irrigation
database_ ___ S stem System
Plumbing Name r , (check all that Other:
Sub- I CL) _ aPp1l )
Contractor Mailing Address Correr Lot YES NO Flag Lot YES I NO
(check one) __ (check ones
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State Zip Phone
issuance,a copy
of all licenses are Oregon Const. Cont.Board txp.Date
required if Lic.#
expired in COT I hearby acknowledge that I have read this application,that the
database Plumbing Lic.# Exp Date information given is correct,thst I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
Oregon State laws. _
Name _ r Sigr�!r!' g Date
Electrical TEL
V) Sub- Mailing Address Co `PeFson me phone#
Contractor JC^alt (7i1-`ll
City/State Zip Phone
Prior to permit
issuance,a copy
FOR OFFICE USE ONLY:
w of all licenses are Oregon Const.Cont Board Exp Date -- ----
require if Lic# Plat# MaprTL#: 2
expired in COT /-
database Electrical Lic # Exp.Date Setbacks: Zone: Solar:
Electrical Supervisor Lic # Exp. Date Engineering App,oval: Planning Approval: TIF:
C-1 r ��
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