11698 SW 125TH COURT ADDRESS:
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CITY OF TIGARD BUILDING PERMIT
PERMIT #. . . . . . . : BUP96-0273
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/22/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8192 (503)e3g.4171
PARCEL: IS133DD-06500
MITE ADDRESS. . . . 11698 SW 1,25-TH C1
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 3 ZONING:R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 104
-------------------------------------------------------------------------------------------
REISSUEt eFLOOR AREAS---------- EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK. :#' FIRST. . . . : 144 sf N: S., E: Wo
TYPE OF USE. . . :SF SECOND. . . : 0 sf PROTECT OPENINGS?-----------
'TYPE OF CONST. :5N
0 sf N: S; E: W:
OCCUPANCY GRP. :R3 TOTAL------: 144 sf ROOF CONST: FIRE RET? i
OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : 1 IIT*: 13 ft GARAGE. . . : 0 s OCCU SEP. RATED:
BSMT? : MEZZ?% REQD SETBACKS-------- REQUIRED---------------------
FLOOR LOAD. . . . : 40 psf LEFTi 0 ft RGHT: 5 ft FIR SPKL: SMOK DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 5 ft FIR ALRM: HNDICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: V1
VALUE. $: 2331
Remar,ks : ACCESSORY BUILDING 12 X 12 90
Owner-: FEES
[ROY CARLS014 type amol.1rit by date V-ecpt
11698 SW 125TH CT PRMT $ 38. 50 JH 05/03/96 96-278969
PLCK $ 25. 03 JH 05/03/96 96-278969
TIGARD OR 97223 5PCT $ 1. 93 JH 05/03/96 96-278969
Pl-ione #: 503-524-4184
L;0ntrlaCt0r'.'
OWNER
Phone'hone $ 65. 46 TOTAL
R,e g
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Footing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foundation Insp
applicable laws. All work will be done in accordance wi',h Framing Insp
approved plans. This permit will expire if work is not started Rain drain Insp
within 180 days of issuance, or if work is sii%pended for more Final Inspection
than 180 days.
l
I er-mittee Signo Lit'ei
Issued
Cal 1 for- inspection 639-4175
1JJ
Residential Building Permit Application �7 \
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
._------
Jr,hsite Address: 5/V
Subdivision: ���� G�S�IHldrt�-C�+Ft Lot# ���I Office Use Only
2 ���f �� LIZIy� Y �� �� Contact Date I ! Initials
Valuation: Result
(A Rt F�
New Construe .on Only: (Square Footage) <�k-r- oU ,e Planck/Rec # ( % ? ! J ' r
<-/ ' Permit # _' 4 -- y .Z 73 _^
House: Garage: ->h� �ZX7Z Reissue of
Corner Lost? � N Flag Lot? Y N Map & TL # 15) �7)DD --C-)
-
.� � A Zone
Owner: �Ce y �v(1 ��c.7I� �i /��� G1/� 5���? Plat # _
Address: � �� s �� C�, Approvals Required
Z?_ -Planning Setbacks '� 4�� olar
Engineering
Phone: ( CI. � 5L
Other
r'7 Items Required
Contractor: QG<.Wer
�� y� Subcontractors
Address:
----��'� Truss Details _
Other
Phone: �_ ) Notes
Contractor's License # IV1 ^— -
(attach cooy of current Oregon license)
Contact Name:
Contact Phone:
Subcontractors: ` ArchitectlEngineer:
Plumbing: _ �/ Address
Mechanical: _ A
rte- N(attach copy of current OR Contractor's License)
Phone:
JOB 7TION: �X 1L '
T
_ ( 503 )Uj
Applicant iqrtature (�� Applicant Phone number
Received by. Date Received: �)=� (�2
-GIXX 5/5
Peermit # Account Description Amount Amt. Pd. Bal. Due
IFC(pp� Z/,C Bldg. Permit (BUILD) �S � , �� • `
Plumb. Permit (PLUMB)
Mech. Permit (MECN) Y
State Tax (TAX) ( ct 3 I a 3
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) 2-5. 103 � �3 C,
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-C)
Water Quality (VVQUAL)
a
Water Quantity 1WQUANT)
Fire Life Safety (FLS)
—� Erosion Cntrl Permit (ERPRMT)
s
CD Erosion PlanckJUSA (ERPLAN)
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Erosion Planck/CO T (EROSN)
Al-
TOTALS:
I CITY OF TIGARD BUILDING INSPECTION NJTICE
II Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service
Foundation Water Line Ceiling -Plumb,
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct, Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _ 0_'C &4& f
Date: A.M. !P.M/ Ent
Address: l�
Tenant: Ste. _ MST:
BUP: — 3
Con/Own: c� y �(�ic- MEC:
CI PLM:
ELC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: Date:
_ROVED _ DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE I
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service —Fi__ tv�Amy
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bld
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: S
Date: CD A.%..—P.M. Entry: —'
Address: j �D )� y7h 1t
Tenant: Ste: MST.
BUP:
Con/Own:_ MEC:
PLM-
ELC:
T FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: + / Date:
_APPROVED ROVFD/CALL FOR REINSP. CF CO
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* OWNERSHIP INFORMATION
*' Reference Parcel #:1S133DD 06500
* Parcel Number :R2009911 TRSQ:01S-01W-33-SE SE
* Owner :CARLSON ROY M JR & DEANNA M
* COOWner
* Site Address :11698 SW 125TH CT TIGARD 97223
* Mail Address :11695 SW 125TH CT TIGARD OR 97223
* Telephone :Owner Tenant
* PROPERTY DESCRIPTION
* Map Grid:655 B3 Class Code:R14
* Census :Tract 319.03 Block 2
* NbrhdCd :MNHL MillRate :13.7036
* Sub/Plat:VILLAGE AT SUMMER LAKE
* Land Use:1012 RES,IMPROVED * I
* Legal :VILLAGE AT SUMMER LAKE PARK NO.3, * i
* :LOT 104, ACRES .17
*
* PROPERTY CHARACTERISTICS
* Bedrooms :3 Lot Acres : .17 Year Built :1990
* Bathrooms Lot SgFt :7,405 EffYearBlt :1990
----- - -____�—. � / _. ,,._„��- 1�..�—• `c�... f 8101
r mr� 1 t !3 7 t .� �•sc 4200 ;.R
94
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5001 84670PLACE
LACE
6000 o9 . �7900
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^`•e "" 4600 �er N�r,L4r i��d 300
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II .1 57'00
1187600 �` '�, \� 9C ?• �' �i:' r,, 4560 4400
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I84
15' 117
106.p1 7700",\ ?`
;300 � 1;' 590C ca.1r ec, ti I7c'
120 I IE ., ~i 6000 6100 •o' so' 40'
�7500/` �` C�Ir N > ``': `-�� i 6200 6300 6400
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APPROVED FOR CONSTRUCTION I
CITY OF TIGARD ! r•
PERMIT NO.BuM-017-3 SITE ADDRESS
BY Z _DATE s z '
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the Oiy of 1 igard,vrtgvi 1, u-
its employees,shall .t be responsible for
N X. A ctscrepancies whichay appear hereon.
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/'bur?Fb 1y91
Permit#: �
Address: C
Issued by: Date: O
Statement: Information Notice to Property Owners
About Construction Responsibilitites
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 he filed with the permit.
I-ill in the appropriate blanks and initial bores i and 2,and either box 3A or 313:
1. I own,reside in,or will reside in the completed structure.
2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
El 3A. My general contractor is —
(Natne) 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. I will be my own general contractor.
If hire subcontractors. I will hire only subcontractors registered with the Construction Contractors
Board. I fl change my mind and hire a general contractor, i will contract with a contractor wha is
registered with the CCB and will immediately notify the office issuing this building permit of the
V' name of the contractor.
r
71 1 hereby certify that the above information is correct and that 1 ImA c read and d►►understand the Information
Notice to Properh• owners abo t C str tion Responsibilities on the reverse side of this form.
w
(Signature of per tpplicant) ( ate►
(While copy to issuing agency permit file,
pink copy to applicant)
CITYOF TIGARD 61D MECHANICAL
COMMUNITY DEVELOPMENT DEPARTMENT PERMI-1
13126 SW HWI Blvd. P.O.Bax 23397,Tiprd,Oregon 97223(600)6394175 7�T7 PERMIT #. . . . . . . MEC92-0142
639-41 E JE 1135LA.D. OC
n1 i E ADDRL-.SS. . . : 11698 SW 125"1"Fl CT PARCEL: IS133DD—.06500
5UBDIVISION. . . . : VILLAGE (4T SUMMER LAKE PARK 3 ZONING: R-4. 5
Bi—OCK. . . . . . . . . . .I LOT. . . . . . . . . . . . . : 104
CLASS OF WORK. . :ADD FLOOR FURN. . . . 'VAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEAT—RS. . : VENT FANG. . . :
OCCUPANCY GRP. . : R3 VENTS W/O APPIL: VENT SYSTEMS:
SIORIES. . . . . . . . . 1. BOTLERG/COMPRESSORS HOODS. . . . . . . :
FW-'-L TYPES------------- 0-3 HP. . . . : 1 DOMES. INCIN:
: /E---LE/ 3--15 HP. . . . t COWL. INCIN.,.
MOX INPUT- BTU 15-30 HP. . . . : REPAIR UNITS:
;:--IRE DAMPERS?. 30-30 HP. . . . : WOODSTOVE5. . .-
OAS PRESSURE. 50+ HP. . . . : CLO DRYERS. . :
NC). OF AIR HANDLING UN I TS OTHER UNITS. :
f-UHN ( 100K LATU: 10000 cfm : GAS OUTLETS. :
TURN )=100K BTU: > 1.0000 c:fm .
Remarks :
Owner: FEEB _._.—___—_--__—_
PUY CARLSON tvpe am 'A n t by date recr)t
11698 SW 1257H CT PRMT $ 25. 00 JLH 06/29/92
5PCT $ 1. .2'7 JLH 0G/29/92
I 1CARD 0 R 9 7 _E'
Pl-ione #:
Contractor:
WN MORISSr--TTE BUILDERS, INC.
I'J555 SW RANGY RD.
#E01
LFAKF- OSWEGO OR 97035 --------------------------------------
Plione #: 6E'0-1538 $ 'b. 25 1 LJ ("L
Req #. . - 35533
-------- REOUIRSD INSPECTIONS
This permit is issued subject to the rpgulations contained in the Final lyispection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be dope in accordance with .......................
approved clans. This permit will expire if work is not started
within 180 days of issuance, or if work is susoended for more
than 180 days.
I'nrmittee Sign, t Lt r
41
C-0 Call for inspection 639-4175
INSPECTION NOTICE
City of Tigard Building Department
M/ \' 13125 SN Be,1 Blvd. Tigard, Oregon 97223
�nopection Line (Rec-O-Phone): 639-4175 Bueinese Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Mech. Rough--in Appr/Sdwlk
•
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Water Line Gyp. Rd. -Mech.
Date Requested/: / C/, `{ Time: AM _ PM
AAdrese:
j ,'S (171-z— Permit #: G�
Builder: :5.2
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY or r'XGARD RECEIPT (IF PAYMENT RECEIPT NO. :92—P.28986
a
CHECK AMOUNT a e6. 25
114AME : TRI COONTY TEMP CONTROL CASH nMOUNT n 14. 00
ADDREOS, a 13651 SE AMBLER RD PAYMENT DATE a (16/29/92
SUBDIVISION
C.-,LPCKAMASv OR 97015—
PURPOSE OF PAYMENT AMOUNT POID PURPOSE OF PAYMENT AMOUNT PAID
lllE-CHANICAL PE f.?5. 00 ST. SUILD PF-.,R 1. 25
C(IRI-90N
i t698 SW 125TH CT
TOTAL AMOUNT PAID 26. 25
City of Tigard MECHANICAL PERMIT Planck/Rec. #
.13125 SW Ball Bird. APPLICATION Permit # _
PO Box 23397
Tigard, OR 97223 '
(503) 639-4171 _
'N—.1 D-1 - escription
Table 3A Mechanical Code QTY PRICE AMT
Job •~ �. �L�, ,�J Nt. • 1) Permit Fee -0- -0- 10.00
Address P
�( \� C1707a3 2) Supplemental Permit 3.00'l r7,a
« . . '1Furnace to 100,000 BTU
1) incl. ducts&vents 6.00
r.v ... �Ry. urnace 100,000 + 7
.50
Owner
I s '�� ��r e 2) incl. ducts&vents
... l c Floor umance
""r QQ "`r{I 1 r 3) incl vent 6.00
« ... Suspended heater,wall heater
f cz,n. 4) or floor mounted heater 6.00
M,J,V — •-• Vent not incl. in
Occupant 5) appliance permit 3.00
Repair of heating,refng.
6) cooling,absorption unit 6.00
II Boiler or comp,heat pump,air cond.
7) to 3 HP absorp unit to 100K BTU 6.00
.a &*— �«»�J. - Boiler or comp,heat pump,air cond.
H)UVDI 8) 3-15 HP absorp unit to 500K BTU 11.00
Contractor C"",. coiit For comp,heat pump,air cond.
1 ' a, 7�\I S 9) 1530 HP absorp unit.5-1 mil BTU 15.00
n. ....«H. Cy o-T.,N. Noi er or comp,treat pump,air cond.
' 10) 3050 HP absorp unit 1-1.75 mil BTU 22.50 j
re y acknowledge that I have reacl this application,that the Boiler or comp,heat pump,air cond.
information given is correct,that I am the owner or authorized agent 11) > 50 HP absorp unit 1.75 mil BTU 31.50 I
of the owner,that plans submitted are in compliance with State Air handling unit to
laws,that I am regist,4red with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM+ 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connecteU
15) to a single duct 3.00
Ventilation system not
f r j 16) included in appliance permit 4.50
.. Hood seryy
�- 17) mechanical exhaust 4.50
De,;cribe work new a ition alteration repair-O Commercial or industrial
to be done residential Q non-residential n 18) type incinerator 30.M
Existing use of Other i.e.,woodstove,water
building or property _ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property
0-
211 More than 4-per outlet
Type of fuel - oil Q natural gas It LPG O electric Q
un
NOTICE
�- Minimum Fee$25,OC SUBTOTAL `w
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
t AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
W ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
J
AFTER WORK IS COMM'"NCFD.
TOTAL
Special Conditions
Date is^ued by -