9062 SW HILL STREET W
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST. ���_ �3/6
24-Hour Inspection Line: 639-41175 Business Line: 639.4171
BUR
707 Date Requested )C` /�AML_PM�/�--
— _- Z,_,,, BLD
Location ,,��,,,�� .�e �)_�C'CX x�tt, yy/ Suite ry q MEC _
Contact Person fi 76eUG() 6tNZ� k- Ph LMLl
Contractor _ Ph _ SWR _
BUILDING Tenant/Owner
Retaining Wall ELR
Footing Access:
Foundationit r � �� , FPS _—
Ftg Drain �' �-'_30
S(;N
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
Misc: -- - - — -- _ — - — ---
Final
PASS PAP.T FAIL
PLUMBING
Post&Beam —
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL _
MECHANICAL
Post& Beam - --- �__�_-- -----
Rough In
Gas Line
S,,yoke Dampers
Final ---- — -- --_—_---
P FAIEL& L
CTRICA — - -- �— --- _
Service _
Rough In
UG/Slab
Low Voltage
F' rm
ASIS • PART FAIL
rm
BacJll/Gradino --
Sanitary Sewer
IFturm Dra:,i ; 1 `411 ':)ec hon feta of$ - required before next inspection. Pay at Cfty Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I 1 Please(all for !fimslw•r h on PF [ j Unable to inspect-no access
ADA
Approach/Sidewalk / f
Other flute = Inspector Ext
Final
PASS PART FAIL_ DU NOT REMOVE th,s inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
21-Hour Inspection Line. 639-4175 Business I-ine: 639-4171 MST --��---�--�-
) BLIP
_
_Date Requested ;�.-�- � --AM_— PM
BLD _
Location G - L�.l.^_\ ` r S//u--itel n C MEC _
Contact Person _ h PLM
ConiracLir _ _ Ph _ SWR
UILDI W Tenant/Owner ELC
Retaining Wall _ ELR
Footing Access: -
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab srr
Post&Beam —
Ext Sheath/Shear
Int Sheath/Shear _ -~ -
Framing
InsulationDrywall Nailing
Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ----------
Roof
Mise --- - - -
S PART FAIL_ ----_ _----_ -_ _-
PLUMBING
Post& Beam --- _ _._ ----- - - _
Under Slab
Top Out -- -. -
Water Service
Sanitarf Sewer
Rain Drains
Final
PASS PART FAIL
MECHAN'',"
Post& Bean --_._-------._ ____-_-----._
Rough In
Gas Line -
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final —
I
PASS PART FAIL
SITE
Backfill/Grading — --------�-- - --
Sanitary Sewer
Storm Drain [ I Reinspection fee of$ required before next inspection. Pav at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ I Please cell for reinspection RE- _- [ I Unable to Inspect-no access
ADA
Approach/Sidewalk Inspector_
Other ` Dated -_-_ s -- ^_ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record front, the job site.
CITY OF TIGARD MASFER PERMIT'
DEVELOPMENT SERVICES PERMIT #. . . . . . . MST98-0164
13125 SW Hall Blvd., Tigard, (7R 97223 (503)639.4171 DATE ISSLIE D: 05/ 14/98
PAR(.'El_.: 2S 10`DB--08800
SITE PDDRESS. . . :0906; SW )AI L.I '
SIJBDIV.SIGN. . . . : ZONIING: ?
BL.00N.. . . . . . . . . . t.f.1T•. . . . . . . . . . . . . .or,,15 JLJR I SD I CT I Ohl: T I 13
Remarks: Addition to SFD PATH I
-------------------------------------------------------------- BUILDING ------------------ --•-----
REI55llE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-----------
CLASS OF WORK.-ADD HEIGHT........: 20 FIRST....: 330 sf GARAGE.....: 0 sf LEFT..........: 5 SMOKE. DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 330 sf FRONT.........; 25 PARSING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 1 FINPSMENT: 0 sf RIGHT.........: 5
OCCUPI'+f1CY GRP.:R3 BDRM: 0 BATH: 0 TOTAL---- 660 sf VALUE..$: 44154 REAR..........: 50
------------------------------------------------.._._..----- --- - PLUMBING --•---------------
SINK;,......... : 0 WATER CLOSETS.: 0 WASHING MACH..: R LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
IHVATORIES....- A DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS.., : 0 C�ARBAC+ DISP..: 0 WATER HEATEW,.: 0 WATER LINE ft: 0 BCKFLW PREVNIR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: a
' -------------- MECPAN1CAL ------- ------ ----------------------------
-----------------------
_----------------- -------
----------------------- -- -------------- ------
FUEL TYPES----------- FURN S IOW ..: 0 BOLI-/,* ( -,W: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0
GAS FUP,N )=100K ..: 0 UNIT W11TGR'.;..: 0 HOODS.—......: 0 OTHER UNITS...: 0
►, MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS......... 6 WOODSTOVES....: 0 GAS OUTLETS...: 0
_.. —--- - --- ------ -----_---_------------ - — -- ELECTRICAL -------------------------
- RESIDENT1Al_ UNIT-- •---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANE(V,15---- --ADD L INSPFCTIONS-
IMM SF OR LESS: 1 0 - 200 amp,.: 0 0 - 20A amp..: 0 W/SVC OR FDR..: 0 POM,-, IRRIGATION: 0 PE2 INSPECTIINV: 0
EA ADD'L 5005F.: 0 201 - 400 amp..: i! 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR........ 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL RR CTR: 0 SIGNAL./PANEL...: 0 IN rLANT......: 0
MANE HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+a1ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----- - ---------------- ------- PLAN REVIEW SECTION ---------------------..--------..._
Reconnect only.: 0 )-4 RES UNITS..: 5VC/FDR)=225 A.: ) 600 V NOMINAL-: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY ---------
A. SF RESIDENTIAL-------------------------- B. COMMERCIAL---—-------------------------------------------------- -------.-_------------
AUDIO I STEREO.: YACIAIM SYSTEM.,: AUDIO E STEREO.: FIRE ALARM.....: INTERCOM/PAGINti: OU1;IOOR LNDSC LT:
BURGLAR ALARM..: OTH: ;; BOILER.........s HVAC...........: LANDSCAPE/IRRIG: PROT,1T1VE SIGfL:
GARAGE OPENER... CLOCK........ .. INSTRUMENTATION: MEDICAL......... 01HR: s:
HVAC...........: DATA/TELE COMM,- NURSE CP.LL.S....: TOTAL A SYSTEMS: 0
Owner: 1OTPA_ FEES:$ 666.26
ANDREW R JARABW AND JAI LENAL JRRAB(NI OWNER, This permit :s subject to the ,-egulations contained in the
'.W,P SW HILL ST Tigard Muni6 i Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone A: 6_10-V89 Phone t: not started within 180 days of issuance, or if the work is
Reg t..: 000000 suspended for more than 180 days. ATTENTION: Oregon law
------------------------------ requires you to follow rules adopted by the Oregon Utility
Notification Center. Thine rules are set forth in OAR 952-081-0010 through OAR St52.001-0080. You may obtain copies of these rules or
direct q+,esti6n5 to UK by callinn 1503)246-1987.
-- REQUIRED INSPECTIONS - --- ---------------- _- _..-----------------------------
Erosion @44-4444 Electric.-al Rough Electrical Final
Footing Insp Framing Insp Mechanical Final
Foundation Ins,, Ras Line Insp Pluet Final
Mechanical Insp ltlz0 ation Insp Building Final
Electrical Servi Rain drain Insp _—�--7—
I s sf Lr e d BY.,- �c__._ F'e r nr i t t e e Signature:�,� • '�'���
+++-:-++++•4-+•++++++++++•++f44+++++•F+++++++++-t•+++++++++++++++•1••++++++ +++++++++++++
ral l r39-4175 I:►y 7:Nr"p. m. for an inspecti.t:n needed the nexy business day
Plan Check e)
CITY•Qh TIG-ARD Residential Building Permit Application Recd By _-6�€0
13126 SW HALL BLVD. New Construction Additions or Alterations Date Recd - -
TIGARD, OR 97223 Single Family Detached or Attache: (Duplex) Dale to P.E.
V 503-639-4171 Date to DST
F 503-684-7297 Permit#
Print or Type Caned .S-/3 --i$ /Oe
Incomplete or illegible applications will not be accepted � yc
r Name of I>roiect - -� --- -��� — - Name --�
Job
Address Site Address
�-_ Architect Maiiing Address
IO fl-i-[ 17'7,1,"le 44,("j 7111 CitNpfney/State Zip =fyh
vi(�l SLC 4J <dLl j C Nq t Name
Owner Mailing Address
d ,[ , C t S
Qd*1State Zip hone Engineer Mailing Address
�• - Name City/State
GZip Phone
enera)
Contractor _t` ) lye4- - Describe work New O Addition QZ" Alteration O Repair O
Mailing Address to be done.
Prior to permit Additional Description o Work: -�---
issuance, a copy City/estateZip Phone .' 1� Ms.fwfl~+ / 17
of all licenses
are required if Oregon Const.Cont Board Exp. Date
PROJECT '
expired in COT Lic.# VALUATION
database _ L
Mechanical Name NEW CONSTR CTI N ONLY:
Sub- 6 L 4CSq. Ft. House: � � Sq. Ft. Garage
Contractor Mailing Address - GU 0
Prior to permit Comer Lot YF,? T-NO —Flag LOt YES NO
,ssuance, a copy City/State Zip Phone (check one) _ (check one) _�-
of all licenses Restricted Audio/Sterer, Burglar
are required!t Oregon Const.Cont. Board Exp. Date Energy System Alarm
expired in COT Lic#
database - I Installation - Garage Door HVAC
Plumbing Name —_ _ Opener S stems
Sub- (check all that Other: -
Contractor Marling Address —` -- apply)
Will the electrical subcontractor wire for all YES NO
_ rest"icted energy installations_?
Prior to permit city/state zip Phone
iWsuence, a copy Has the Subdivision Plat recorded? N/A YES NO
of all licenses are Oregon Const.Cont.Board Exp.Date _
required if Lica Reissue of MST#: Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic.# Exp. Date' I hearby acknowledge that I have read this application,that the
information given is correct,that I am the owner or authorized
Name agent of the oviner, and that plans submitted are in compliance
with OregQn State laws. _
Electrical Sign ttGreof m-r/Ag / Date
Sub- Mailing Address
Contractor Cct" erson N e / Pone#
City/Statc 7_ip Phone r �2
Prior to permit FOR OFFICE USE OILY:
issuance,a copy _ Plat#: I
of all licenses are Oregon Const.Cont.Board Exp Date 1
required it Uc.a Setback%: 1 �
e �
expired in COT Zone: S01air,
database Electrical Lic.a Exp. Date
4r ►�
ginPring prOvaL•�- Planning Approval: TIF;
I.SFREM.DOC (DST) 4/97
Issued by:� Date:
Igg �
Statement: Information Nolice to Property owners
About Corlstructio►,i Responsibilities
Note. Oregon Law, URS 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 issf.:d This statement is required
for residential building, electrical. mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt,lrom registration under ORS 701.1710(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
1. 1 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.
F] (Name)
My general contractor is
(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
3B. I will be my own general contractor,
If I hire subcontractors, I will hire onl! subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a ge.ieral contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this b�dl(Cag permit of the
name of the contractor.
I hereby certify that the a!)ove information is correct an i that i have read and do understand the Information
Notice to Pro O ers abo onstruction Responsibilities cin the reverse side of this form.
7'
( gnature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
tntorrnabovi Notice to Property Owners
AY:.)out Construction ResponsitYiMies
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