10955-10957 SW 121ST AVENUE ADDRESS:
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CITY CF TIGARD 1,Ecl2MIR #.. I. .. . .
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/05/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PAr�cEl_: 1 S 1 v4Eil,-90061c
1-E: ADDIRES S. . . : 109::55 ::'DW 121`;'T AVE
':,UPD I V I S I LAN. . . . : WOODSPI R I TVG CONDOS ZONING: R-7
,LOCK. . . . . . . . . . . LCTT. . . I .. . . . . . . . . ..
Remarks: INSTALLING 2 WINDOWS IN END OF HOUSE
-----------------------------•-------------•------------ ------ BUILDING -------------------
REISSIIE: STORIES.......: I FLOOR PREAS---------- BASEMENT...: 0 sf REQUIRED SETBP�KS---- REQUIRED------------
CLASS OF WORK. :AL1 HEIGHT........: 0 FIFST....: 0 sf GARAGE.,...: 0 sf LEFT.........,; 0 SMOKE DE'iECTRS:
TYPE OF USE...:SF FLOOR LOAD....: 0 SECOND...: P sf FRONT......... : 0 '4RKING SPPc=S: 0
TYPE OF CONST.:SN DWELLING UNITS: 0 FINBSMENT: 0 5f RIGHT.........: 0
OCCUPANCY GRP.-R3 BORM: 0 BATH: 0 TOTAL------: 0 sf VALUE_$: 1000 REAR..........: 0
--------------------------------------------------------------- PLUMBING --------------------------------------------•-------------------
SINKS.........: 0 WATER CLOSETS.: 0 HASHING MACH..: 0 LAUNDRY fRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 0 DISHW;C t►fS...: 0 FLOOR DRAINS.. ; 8 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUE/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS. : 0 WATER LINE ft: 0 BCKFLW PREVNIR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
---------------•----------------------------------------------- MECHANICAL --------------------------------------------------------------
FUEL TYPES----------- FURN ' INK ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0
FURN )=INK ..: 0 UNIT "EATERS..: 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: a BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
-------------------------------------------------------------- ELECTRICAL --------------------------------------------------------------- -
-RESIDENTIAL
------------------------ - --
-RESIDENTIAL LNIT--- ---SERVICE/GEEnER---- --TcNP SRVC/FEcDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIUNS--
1000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP!IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 20! - 400 amp..; 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR...... : 0
LIMITED ENtRGY, : 0 401 600 amp..-, 0 401 - 600 amp,.: 0 EA ADDL cR CIF: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FnR: 0 601 - 1000 amp.: 0 601+amp5-1000 v: 0 MINOR LABEL -10: 0
:000+ amp/volt.: 0 -------------------------•---------- PLAN REVIEW SECTION ----------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.,: ) 600 V NOMINAL: CLS AREA/SPC OCCi
------------I----------------------------------------- ELECThICAL - RESTRICTED ENERGY ---------------------------------------------------
A.
---•----------------------------------------------
A. 5F RESIDENTINL---------------------------- B. C3WRCIAL-----------------------------------------------------------------------------
AUDIO b STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAtl[NG: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: 1NSTRUMENTATICNi MEDICAL........: OT+R:
HVAC...........: DATA!TELE COMM.: NURSE CALLS....: TOTAL. M SYSTEMS: 0
Owner; -----------------------------------Contractor; ------------------------------ TOTAL FEES:/ 42.50
JOHN GRUNDTNER DON DUNN
10955 SW 121ST AVE :6040 SW JOHNSON RD
TIGARD OR 97223 CLACKAMAS OR 97015
Prone N: 579-3301 Phone M: 557--5082
Reg C.: 111028
This permit is Issued subject to the regulations contained it the Tigard M,Inicipal Code, State of Ore. Specialty Codes arra all other-
s_
applicable laws. E,li work will he done in acco-dance with approved plans. ;s permit will expire if work is not started within 180
days of issuan:e, or if work is suspended for more than 180 days.
-------------------------------------------------------- REOUIRED INSPECTIONS ------------•-----•-----------------------------------
Framing Insp — -
-_� Insulation InsF
r Gyp Board Insp _
Buildinq Final
oi-mittee ;.3iF3rratUr•e : _� -�- 1s5tied Lt�� fig _ �•
all for inspection - 639-4175
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riF'�M a t3RUNT)lNE R, .TORN (MM-4 014 )UN't IV). 00
FAM)RIM,as 10955 Sw 12181, AVE PAYMENT UA f f'- ,,1 96
T I GARD OR 6UBD I V IS VIN e
97�>R$3-
PURPOSE. CSF= PAYMENT AMOUNT PA i D PURPOSE IAF' VNYMh NT r1MUUN I P1410
BUJI-NNO PLAN CW-X P.5
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14A9 15 taw 1 r?UBT AVF-:
PI 0N 01FICK #06-116N r�
UITY Of,". 71UHHO 1470AIll 1.11, [,i4YMkAql Rj- I F.-I 1 1140. cl-lt—
t.'HR(-K 1-0,11 11 li,l f : o.
NINE a (3AUND*TNF.R# JU14N L;Hi3il "Mi"j" 1 00
ADDRE-Sa A I(#got sw A R I S'r A V L- PRYMLNI 1,011-
T I SARD UH Wilb I V
97p23._
1,A IWAL181-i OF PAYMENT (41401 IN 1 PAI 1) ISL.RPI CIV 1-'0Yfvlf-%Nl (1010,111 11pil1,
i(T,l*A-)I`N-0,, PERM M81941-11314" ?5. OLA qT. SURD ill."
10955 Sw telst AVE
ms,i96-0337
TOTAL AMOUNT PAID R6 eb 611 .ddo
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service i;FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect
P(,st/Beam Struct Mech, Rough-in Gyp Bd.
San. Sewer Gas Line Appr/Sdwlk Reins.
Otl ie,:
De:ce: —9 (' A.M. — -P.M. — Entry:-- -- --
Address: /,6 _
Tenant: Ste: MST: 9(,c C)3-
BLIP: .3BUP:
MEC:
PLM:
ELC: —
FH�E FOLLOWING CORRECTIONS A9E REQUIRED: ELR: _
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Inspector: - Date:
_._APPROVED _DISAPPROVE D/GALL FOR REINSP. C1' CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath r__rr�rning -Meeh.
PIbg.IJnd/Flr/Slab Plbg. Top Out Insulation Elect.
Post/Beam Struct. Mech. Rough-in �'y')'S'�'d. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: ��_
Date: ?''-- 2- 9L A.M.,—P.M. Entry:
Address: 1ST S3� / 7�/
Tenant_ S`7 �3 I Ste:_, MST: __59L..V
BUP:
Con/Own:.— _- MEC: _
PL-M: _
ELC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR-
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In�spee or- Date: Z
_APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing R4in Drair, Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr,'ilab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Lin,-- Appr/Sdwlk Reins.
Other: .��(I'�'�-�")41t/ ,L 64," tA4_c4.4_
Date: 7 — 1(0 - A.M. —P.M.— Entry-
Address: _ l Q�S-9 5 LL) I ;I_ w"Irl S104111-tz ti
Tenant: _—_ _ Ste: MST:/4 `0 33 7
%_11 tea 5`29-00-3MEC
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Con/Own:__ �_ MEC_) C
PLM
-U�•�-!< </3Y ? Z 3 ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
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Inspector: Date
APPROVED __DISAPPROVED/CAL RREINS Cr' CO
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
�1
Subdivision: ���(`l�kl P�`t N� Lot # Office Use Only
j Contact Date 7;;F1 � mi!:aIs�
Valuation: LO- 111) __ Res0 1/-
New Construction Only: (Square Footage) P,!
ancl:/Rec #
Permit # t — D-3 3��
House Garage: —_ Reissue of 4.-(
Corner Lot? Y N Fla Lot? Y N Map & TL # iSt-31 �'rvr•L�
Flag Zone
JDto, Plat # �
Owner: _
�, C1 � Y— Approvals Required
Address: i / _0 /d "
(2-, Planning Setbacks r _ Solav LA
Engineering
Phone: O'her
Contractor:
��l L1 N r\1 Items Required
V
�, a S ����� Subcontractors _—
Address: �,�/� ,,,�,� /► Truss Details
— L�' `1 V Y" � � ��� ��(' j Other
�
Notes �
`1
Phone:
Contractor's License #
(attach copy of current Oregon license)
Contact Name. —r—'
Contact Phone: L`
Subcontractors: Architect]Engineer: —
Plumbing _ Address' --- ---- --___-__
Ci Mechanical
(at,'-,c,) copy of current OR Contractor's License)
Y Phone:
J_ JOB DESCRIPTION: L L LA,1
LA-
-' Applicant Signature Applicant Phone number
Received by: Date Received. _
H bpndNVN1p0 '
Permit ;$ Account Description Amount Amt. Pd. Bal. Due
/71$ C}.� j Bldg. Permit (BUILD)
_ Plumb. Permit (PLUMB)
Mech. Permit (MECN)
State Tax (TAX) / �� �_'
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parka Dev Charge (PKSDC)
Residentlal 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)
c�
Water Quantity (WQUANT) _
Fire Life Safety (FLS)
Erosion Cntri Permit (ERPRMT)
it
Erosion Planck/USA (ERPLAN)
_.osicn PlancklCOT (EROSN)
TOTALS: 2, 0 i
The.City of Tigard, Oregon,or
Its respons; ie for a
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