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MASTER PERMIT
CITY CF TIGARD PERMIT#: fvIST2000-00147
DEVELOPMENT SERVICES DATE ISSUED: 06/09/2000
13125 :W Hall Blvd , Tigard, OR 9722" (503) 639-4171
SITE ADL`RESS: 08679 SW HAMLET CT PARCEL: 21117 111 DD-15700
SUBDIV SION: MILLMONT PARK ZON;NG: R r
L—OCK: LOT:034 JURISDiGTION: TIG
REMARKS: ADDING 256 SQ FT. TO EXISTING HOUSE
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 11 FIRST: 2�A al BASEMENT: at LEFT: 6 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: at GARAGE: sl FRONT: 39 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: F'NBSMENT: of RIGHT: 6
VALUE. $16,168.32
OCCUPANCY GRP: R3 BORM: BATH: TOTAL: 25600 at REAR: 24
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TPAYS: RAIN DRAIN: TRAPS'
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH RASINS:
TUO/SHOWERS: GARBAGE DISP: WATER HEATERa. WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES.
MECHANICAL _
FUEL TYPES FURN '00K: BOIUCMP<3HP: VENT FANS: CLOTHES DRYER:
GAS FURN>-100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: +tu ROOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS:
_ ELECTRICAL
RESIDENTIAL UNIT M SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS_ ADUL INSPECTIONS
1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC CP,FOR: 1 PUMP/IRRIGATION: PER INSPECTION-
EA AD.)'L 5005F: 201 400 amp: 201 4n0 amp: 1st W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT.
MANU HMISVC/FDR: 601 1000 amp: 6'.1+amps•1000v: MINOR LABEL:
I00+amptvolt
PLAN nEVIEW SECTION
Reconnect only:
>•4 RES UNITS: 9VClFDR>•225 A.: >800 V NOMINAL: CLS AREA/SP:OCC.
ELECTRICAL•RESTRICTED ENERGY _
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDC OR LNL3C LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIUNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OT 4R:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL,'SYSTEMS:
1
Owner: Contractor: TOTAL FEES: . 547.04
3MIC�,PEF RY DlDEENAA OWNER This permit Is subbed to the regulations contained in the
HAMLET CT Tigard Municipal Code,State )'OR Specialty Codes and
8679 SW
TIGARD, HA LET all other applicable laws .ATI woI k will be done in
accordance with approved plans. This permit will exp�e Il
work is not started within 180 days of issl-enoe,or if the
work is suspended for more than 187 days ATTENTION
Phone: Phone: Oregon law requires you to follow rul-s adopted by the
Oregon Utility Notificati,m Center. Those rules are set
Rau n forth in OAR 952-001-0010 through 952-001-0080 YoL-
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQI TIRED INSPECTIONS
Fooling Insp Electrical Rough In Mechanical Fina` _
Slab Insp Framing Insp Numb Finel
Underfloor insulation Insulation Inco Final Ins ectiun ORIGINAL
Mechanical Insp Rain drain Insp
Electrical Service Electrical inal
Issued Bye; Permittee Signature : `=�
. Call (503) 6394165-
by 7:00 p.m. for an inspection needed the next business day
Permit#: 3�' oR000 — odlel
OF O
- Address:
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Issued by:
/3059
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
fo owing statement eforuiln`g permrt ranlssued. i c 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 healed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2,and either box 3A or 3B:
gr!. 1 own, reside in, or will reside in the completed structure.
2. 1 understand that i must register as a coi itruction contractor if the structure is sold or offered for sale
before or upon completion.
J 3A. My general contractor is
J (Name) Contractor regis. #
1 will instruc. 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 1 hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire j 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.
I hereby certify that the above information-is correct and that 1 have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
(Sign Lire of permit applicant) ( ate)
(White cope to issuing agency permitfile.
pink copy to applicant)
s nforrnc-tion Notice to Property fawners
About Construction Responsibilities
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CITY OF TIGARD Residential Building Permit Application Plan Check#�
'13125 SW HALL BLVD. Additions or Alterations Recd By�
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date Recd, /— G�� —
V en`l-639-4171 Date to P E.
F 50 s-bb4-7297f Date to DST '`J
r ( �
Permit#/V)r,4&LV-0���/7
Print or Type Called
Incomplete or illegible applications will not be accepted �3a-oo$ ,/7Z
Name Of Pro ect Name
Job 5 .1r,�n
Address Site Address
"�- -- Architect Mailing Address
Name I . - - - City/State Zip Phone
lf tZ.A4 �n11�J4G --- - Name - -—
Owner Mallin res s
e
8� 4� Engineer Mailing Addrrss
Cit !State ►� v']Zip�e� /-Phone g
General Na. e
—+'�='--1 Phone City/State Zip Phone
Contractor NA - 54( p Describe work New O Addition• Alteration O Repair O
Mailing Address P�cto be done
Prior to permit Additional Description of Work
Issuance,a copy Cfty/State Zip Phone
of all licenses
are required If Oregon Const.Cont. Board Exp.Date PROJECT 3 z
expired in COT Lica VALUATION
database - _ _
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- R - �j�t Sq. Ft, House. Sq. Ft Garage
Contractor Mailing Address _- gy i ___
Prior to permit Indicate the restricted en rnstallation 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.Ccnt.Board Exp. Date Energy Sys*tein Alarms
expired in COT Lic# Installations Vacuum Irrigation
databaseName S ste_m__ _ System
� _
Plumbing (check all that Other:
Sub- -- �Ot�l� -apply)
Contractor Mailing Address _ -- Corner Lot YES NO Flag Lot YES NO
__(check one check one)
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A YES NO
issuance,a copy - ------
of all licenses are Oregon Const. Cont.Board Exp.Date
required if tic# _
expired in COT I hearby acknowledge that I have read this application,that the
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 State laws.
Name a ure of Owner/A nt Date
Electrical - r„1'G(-�
Sub- ailing Addressgtact�Pers�Nam S �' 1 C Phone#
Contractor — —JJ N -Sb' a
City/State Zip Phone
Prior to permit
issuance,a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const.Cont Board Exp Date plat#
required If Lic# Map
expired In COT _ _ ���' S�
database Electrical Lic Ar Exp. Data tbacks. Zone: �pproval:
Electrical Superyisor Lic #r Exp Daae Engin� ina Approval: Planning TIF
I:\dsts\forms\sfaddaIt.doc 14/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MSl' -
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
"up
_
_rDate Requested /- 2 -6) --------AM— PM -- _ BLD
Location `✓ t�C� Suite MEC
Contact Person Ila 01 C-14 Ph �f 2F - 3X5.3 PLM
Contractor Ph SWR
Tenant/Owner _�r,.�.f �I�fi d 44"a/iC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Fig Drain SGN
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 %
FART TAIL ----
ING
Post&Beam _
Under Slab
Top Out
Water Service +
Sanitary Sewer
Rain Drains
Fina,
PASS PART FAIL
Rough In
Gas Line - - -- --
S oke hampers
FAIT_
Service _- __
Rough In
UG/Slab
Low Voltage
Fire Alarm --_�
na
PART FAIL
Backfill/Grading
Sanitary Sewer
Story+..Drain [ j Reinspection fPa of$— — required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RF _- _ [ ]Unable is inspect no access
ADA
Approach/Sidewalk
Other - Date
Inspector@CtOr Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.