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9765 SO FRT7VING STREET
CITY OF TIGARD BUILDING= INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
lBUP
Date Requested (01, AM —PM — BLD
Location_ 7s n.(cS7" Suite MEC
f --- -
Contact Person Ph _��>���� PLM
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Contractor o `' —_ Ph — SWR _
fUILIING� Tenant/Owner — EL.0
Retaining Wall V ELR
Footing Access:
Foundation FPS
Fig Drain _ SIGN
Crawl Drain Inspection Notes: --- ----
Slab -------------- _ -- -- -_-- SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _-
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
3sft99� PART FAIL - - - -- --- - - - --- --- - -- -
MBING
Post&Beam � .-- --- - -- ---- - -------
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL _-_--
MECHANICAL
Post& Beam -- - -
Rough In
Gas Line —
Smoke Dampers
Final — - -
PASS PART FAIL
ELECTRICAL —
Service -
Rough In
UG/Slob ---
Low Voltage
Fire Alarm _ - -
Final
PASS PART FAIL ---
SITE - -- --- -
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ _-_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I J Please call for reinspection RE _ _ ._�-- [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Late �Q- _Sp_ Inspector _- Ext
Other ---- - E '' - -----
Final
PASS PART FAIL 00 NOl" REMOVE this inspection retortl from the job site.
MASTER PERMIT
CITYOF TIGARD PERMIT#: MST1999-00170
DEVELOPMENT SERVICES DATE ISSUED: 5/19/99
13125 SW Ball Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 09765 SW FREWING ST PARCEL.: 2S102CA-00102
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5
BLOCK: LOT: 021 JURISDICTION: TIG
REMARKS: Addiiion - accessory unit attached to existing single family dwelling.
BUILDIN
REISSl1E'.
STORIES FLOOR AREAS REQUIRED SETBACKS^ REQUIRED _
CLASS OF WORK: AD[., HEIGHT: I I FIRST: st BASEMENT: at LEFT: '3 SMOKE DETF.. 3R5.
TYPE OF USE: 5F FLOOR LOAD: 5r,. SECOND: al GARAGE: 400 at FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT. er VALUE: S 7,340.00 RIGHT:
OCCUPANCY GRP: n3 BDRM: BAT4�
TOTAL: of REAR: `+y
PLUMBING
SINKSWATER CLOSETS. WASHING MACH: LAUNDRY TPAYS:
RAIN DRAIN: TRAPS:
LAVATORIES. DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS
CATCH BASINS:
7JD%SHOWERS: GARBAGE GISP: WATER HEATERS: W4TER LINES: BCKFLW PREVNTR.
GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES
FI)RN<100K: BOILICMP<3HP: VENT FANS: CI OTHES DRYER.
FURN>-100K. UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOP FURNANCES-.
VENTS: WOODSTOVES: GAS OUTLETS'.
ELECTRICAL _
BRANCHCIRCUIT3 MISCELLANEOUS _ ADD'LINSPECTIONS
RESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRVCIFEEDERS —
1r00 SF OR LESS: 0 200 amp:
0 200 amp: WISVC OR FDR. PUMPIIRRIGA'ION: PER INSPECTION.
E.N ADD'L 5005F, 201 400 amp'.
201 400 amp: 1st W/O SVCIFDR: 31GNOUT LIN LT: PER HOUR.
LIMBED ENERGY: 401 600 anur.
401 - 600 amu: EA ADDL BR CIR. SIGNAL/PANEL: IN PLANT.
MANU HMISVCIFDR:
601 tOno amp: 601+amns-11000v MINOR LABEL
1000-amolvolt. PLAN REVIEW SECTION
Reconnect only: >=4 RES UNITS: 5VCIFOR>=225 A.: >600 V NOMINAL: CLS AREAISPC OCC'
ELECTRICAL•RESTRICTED ENERGY ---
-- B.COMMERCIAL. .
A.SF RESIDENTIAL �_.______---------
AJDIO&STEREO VACIIUM SYSTEM: AUDIO 8 51 ERE0 FIRE ALARM INS ERCUMIPAGING: OUTDOOR LNOSC LT:
F URGI AR ALARM 01 H'.
BOLI:R: HVAC: I.ANDSCAPFARRIG: PROTECTIVE SIGNL:
GARAGE OPENER.
CLOCK: INSTRUMENTATION MEDICAL: OTHR:
HVAC
DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS.
TOTAL FEES: $ 156.46
Owner: Contractor: This permit Is subject'a the regulations contained in the
JEFF DOAN OWNER Tigard Municipal Code.State of OR Specialty Codes and
9765 SW FREWING ST SIGNED RESPONSIBILITY FORM all othe applicable laws All work will be done in
TIGARD.OR 97223 IN FILE accordance with approved plans This permit will expire if
work is not started within 180 days of issuance,or if the
work 1s suspended for more than 180 days ATTENTION
Phono Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Rep M, forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion 844-8444 Ruilding Final
Footing Insp ORIGINAL
FoundationInsp
Framing Insp
Final inspection
Issued By :
�� � Iil,�'% Permittee Signature :_
_ ------
Call ,503) 639-4175 by 7:00 p.m. for an inspection ner-ded the next business d y
CITY OF TIGARD Residential Building Permit Application Plan Check ��5
13125 SW HALL BLVD. Additions or Alterations Recd By
_
TI aARD, OR 97223 Single Family Deta-hed or Attached (Duplex) d
DDate ate RReccto P E
V 503-639-4171 Date to DST _„
F 503-684-7297 Permit# r#7r/fir
Print or Type - Called_�`/�fq ' -
Incomplete or illegible applications will not be accepted
Name of Project Name ^
Architect fAailin�9 A drass
Address Site Address"S LL
L -
Narne City/State Zip Phone
1'_'4 CCS _ ——�— — Name
Owner Mailing Address .
City/State Zip Phorro U Engineer Mailing Address
U' �.
--- - - D - City/State Zip Phone
General Na
Contractor De-,cribe work New O Addition O Alteration O Repair O
Mailing Address to be done: _
Prior to permit _ Addijliq I escnption of Work: (� Q
issuance,a copy City/State Zip Phone — 4V w r\
of all licenses
are required if Oregon Const.Cont. Board Exp. Date PROJECT C `�
expired in COT Lic#
database VALUATION
_ t
Mechanical Name ---� - NEWr,ONSTRUCTIONONLY:
Sub- '' Q �C~ Sq. Ft. house Sq. Ft. Garage
g Add
Mailing
Contractor Indicate the restricted energy installation by the a electrical
Prior to permit subcontractor in the following areas
issuance,a copy City/State Zip Phone
of all licenses Restricted Audio/Stereo
are required it Oregon onst Cont rd Exp.Dale Energy S stem Alarms
expired in COT Lic# Installations Vacuum Irrigation
database _ _System__ _.__System
Plumbing Name (check all that Other.
Sub- luj -c v- apply)
Contractor Meiling Ad ess — — Currier Lot YES NO Flag Lot YES NO
(check one _ _ _ (check one) _
_ Has the Subdivision Plat rerorded? N/A YES NO
Prior to permit City/State Zip Phone
issuance,a copy ------ —_— ----- ---of all licenses are Ore on Cor► t Co Board Ex Date
required if Lic � p I hearb acknowledge that I have read this application,that the
expired In CUT Y 9 PP
database Plumbing Lic # Exp. Date information given is correct,that I am the owner or authorized agent
of the owner,and that plans submitted are in compliance with
Oregon Stale, ws. _
Name Signatu o,6fer/ 1 Date
Electrical �� _ -
Sub- Mailing Add ss - -- Co tact PerspA Nam � Phone#
Contractor �1
City/State% Zip Phone l"o���f��a� ��A n S9�" �9 0Prior to permit a -f
issuance,a cop, FOR OFFICE USE ONLY: _
of all licenses aie Orego Const Cont B rd Exp Date --- -- --
required if Lic#/ Map[TI
Plat#:
expired in COT �'
database Electrical Lic # N Exp Date Setbacks Zone �� Sola;: l
Electrical Supervisor Licc # Exp Date Engineering Approval, Planning Approtral: TIF:
i\dsts\forms\sfaddalt doc 11/20/98
6iu��LtJ,
Permit #: L3G-/y'99�00/�O
• Address:
4F
. �,�.� .;.;. n
N ? Z Issued byDate:
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 DRS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
c
Fill in t appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
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1. 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.
f 3A. My general contractor is —
lJ (Name) 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
3QEf'.1B. 1 will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
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 immediately notify the office issuing this building permit of the
name of the contractor. r
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Propert Owners about Construction Responsibilities on the reverse side of this form.
s
(Si iture of permit applicant) (Date)
i
(White copy to issuing agency permit,/ile,
pink copy to applicant)
Information Notice to Property, Owners
About C;Onstruction Responsibilities
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EMPLOYER RESPONSIBILITIES:
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