10466 SW LADY MARION DRIVE i
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CITY OF TIGARD BUILDING INSPECTION DIVISION Msr
24-Hour Inspection Line: 639-4175 Business Line• 639-4171
BLIP _
Date Requested_,_ (o'�1 �1 C7� AM PM BLD
Lacatior L)L� �� �._t�1��1( 0^Suite MEC
Contact Person le" Ph ,��� 1-(.429 PLM
Contractor Ph SWR
ILD Tenant/Owner ELC
Retaining Wall ELR _
rooting Access:
Foundation FPS
Fig Drain SIGN
Crawl Drain Inspection Notes: �,/' S �---�--- ----
Slab --- -----v � /I ,� + I' �'��' SIT
Post&Beam
Ext Sheath/Shear
Int Shea!h/Shear -- -
Framing
Insulation
Drywall Nailing
Firewall
re Sprinkler
- - ------------------------
irire Alarm
Susp'd Ceiling ---------___--- -
Roof
Misc ---- _- _ —�-- ----
PASS PART FAIL_
Post& Deem --------- ..._-------------- - --------- ---__ __ ----
Under Slab
Top Out i _ . - -- - - - - -------__
Water Service
Sanitary Sewer
Rain Drains
PART FAIL
- -
Post & Be i - _ - - ---- -- -- --_ - --- ---
Rough In
Gas Line -- - - - _ - ----- ---------- -
Smoke Dampers
y -- - - --- - - - ------------ --- -
rill
6, PART FAIL
Service
Rough In
UG/Slab
Low Voltage ---_-- ---- --- - -
Fire Alarm
Final
PASS PART FAIL
SITE
BackfilUGrP.ding --------___--
Sanitary fewer
Storm Orain ( ]Reinspection fee of$__. -_-required befcre next inspection. Pay at City Hall, 13125 SW Hall blvd
Cat,n Basin ( ]Please call for reinspection RF _ _ ( ]Urible to Inspect-no access
Fire Supply Line
ADA
Appioe.ch/Sidewalk Date Ext
'ether
Final
PASS PART FAIL DO NOT REMOVE this inspection, record from the job site.
s
CITY OF TIGARD BUILDING It ISPECTION DIVISION
24-Hour Inspection Line: 639-4175 Businesz, Line: 639-4171
BUP
Date -,equestedAM PM BLD
Location, [ l '�-f �(' L Gt j" ___ •'__.f OA -quite MEC
Contact Person,- '7 C Ph PLM
a
Contractor (2-C e_e {/va-<_ L c c- �,y Ph SWR —
F'i,L)ING Tenant/own,:rELC �—
Retaining`.Nall ELR
Footing Accc,s
Foundation // M FPS
Ftg DI qin �'` Y:12 C% s C ,��TA/Z/c.�
Crawl Drain Inspection Notes: SGN
Sli:,b C'4,'lJ��( r --- -- SIT -- --
Post& Pearn
Ext Sheath/Shear
Int Sheath/Shear --
r
Framing --
Insulation `y
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling _.-
Roof
Misc - --- --
Final
PASS PART FAIL ---------------.._ ------- l 1
PLUMBING
Post& Berm - --------- -
Under Slab
Top out I T
Water Service
Sanitary Sewer
Rain Drair,s
Final _ ----_--_---- --
PASS PART i AII_
MECHANICAL '------`—
Post&Beam --
Rough In
Vas Line —
S-noke Dampers
Final --- ---- -
PASS E&RT FAIL
ECTRIC t
r' -
SerVICe
Rough In
UG/Slab
t ow Voltage
Fire Alarm
incl
SS ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE 1 I Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date z_-_ ..' _� Z,. Inspector 'L Ext
Final
PASS PART FAIL DJ NOT n MOVE this inspection record from the job site.
FFP1a11 : PERT I I!E ELECTP I r LLC FAX N0. : 503 982 0926 Apr-. 06 2000 0.5:11AI1 P1
CITY OF TIGARD
13125 SW HALL BLVD.
TIGARD. OR 97223
IMPORTANT PERMIT NOTICE
CREATIVE ELECTRJC INC
13220 BETHLEHEM DR NE
GERVAIB, OR 97206
Electrical Signature Form
Permit#: MST2000.00043
udte Issued: 0212412000 pooR OIIAI.ITY ORi(ANAL
Parcel: 25111CB-04400 6Fsi ALNR()r)UUTIt_,;'AVAILABLE
Site Address: 104x86 SW LADY MARION DR
Subdivision- MARION ESTATES
Block: Lot: 017
Jurisdiction: TIG
Toning: R-3.5
Remarks: Construction of 500 square foot addition to existing sin5ple family residence.
Your compan,,has been indicated as the electrical contractor for the permit indicated above In order for the
electrical permit to be valid,the signature of the supervising electrlr_lan is required. F1985e have the
appropriate individual from your company sign below and retum thls Electrical S-Ignature Form prior to the
start of the work to the nddresa above.A I I N: Building Dept
No eloctrlcail Inspections will be authorized until *iris completed form is received
OWNER: ELECTRICAL GO^ITRA::TOR:
NORGART, : kNDAL.L E t STACEY L CREATIVE_ ELECTRIC INC
1044% SW LADY MARION DR 13220 BETHLEHEM DR NE
TIGARD. OR 97224 GERVAIS, OR 97206
Phone #: Fhone #. 603-982-0926
Roo #: uc 129761
sur
ELF 24—WC
AN INK SIGNATURE IS REQUIRED ON THIS FORM
XL - -��=sr-9s
SI natirr. of Sup ising Elec'rician
If you have any qudstlons, please call (503)639--4171, ext. # 310
MASTE
ERMIT
CITY 0, TIGARD � PERMIT
: MST2
ww`` PERMIT#: MST2000-00043
DEVELOPMENT SERVICES DATE ISSUED: 2/24/00
13125 SW Hall Blvd.,Tigard, OR 97223 (5-
SITE
5SITE ADDRESS: 10466 SW LADY M/\RION DR PARCEL: 2S111CB-04400
SUBDIVISION: MARION ESTATES ZONING: R-3.5
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: Construction of 500 square toot addition to existing single tarnily residence.
BUILDING —_
REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 500 of BASEMENT. at LEFT _, SMOKE DETFGTORS: f
TYPE OF USE: SF FLOOR LOAD. 44 SECOND: sf GARAGE. s' FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING,UNITS. 1 FINBSMENT sf RIGHT: 5
VALUE: 485 OU
OCCUPANCY GiIP: R3 HDRVI! BATH: TOTAL. sf REAR: .,o
PL.;"'P;NG ..
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DI'.HWASHERS. FLOOR DRAINS: SI SJF.R LINES. SF RAIN DRAINS: CATCK dASINS:
TUSISHOWERS: '.ARRAGE DISP WATER HEATERS: WATER LINES. BCKFLW PREVNTR. GREASE TRAPS.
OTHER FIXTURES,
MECHANICAL
FUEL TYPES FURN�100W BOIUCMP*3HP VENT FANS: CLOTHES DR`;ER:
,AS FURN—100K: UNIT HEA I'FRS HOODS: OTHER UNITS: I
MAX INP: bt n FLOOR FURNANCES: VENTS. I WOODSTOVES: GAS OUTLETS.
ELEC rRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _MISCELLANEOUS AUD'L INSPEC TIONS
1000 SF OR LESS: 0 200 amp: 0 200 amp. WISVC OR FOR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500sr: 201 400 amp: 201 400 amp: 1st WIO SVCIFDR. SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp. 401 - 600 amp, EA.ADDL BR CIH: SIGNALIPANEL IN PLANT
MANU HMISVCIFDR: 601 - 1000 amp: 601-amps-1000v. MINOR LABEL
1000.amplvoll
PLAN REVIEW SECTION _^
Reconnect nnly: —�
+=4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINnI CLS AREA/SPC, "6.
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL _
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO. FIRE ALARM. INTERCOMIPAGING: Out DOOR LNDSC L r.
BURGLAR ALARM. OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNI.:
GARAGE OPENER: CLOCK. INSTRUMENTATION. MEDICAL: OTHR:
HVAC DATA/TELF.COMM: N1IRSF.CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: $ 777.29
Owner: Contractor:
1 his permit is subject to the regulations contained in the
NORGART, RANDALL E+STACEY L OWNER Tigard Municipal Code, State of OR Specialty Codes and
166 SW LADY MARION DR all other applicable laws All work will be done in
TIGAPD,OR 97224 accordance with approved plans This permit will expire-f
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENT ION.
Phone. Phone Oregon law rec-.fres you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Reg a: forth in OAR 952-001-0010 through 952-001-0080 Yo,)
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
RCQUIRED INSPECTIONS
Erosion 844-8444 Post/BPam Mechanica Electrical Service Electrical Final
-5 ,A0en Underfloor insulation Gas Line Insp Mechanical Final
Footing Insp Crawl Drain/Backwater Gas Fireplace Plumb F;nal
Foundaton Insp Footing/Foundation Dr; Insulation Insp Final Inspection
PosUHet,,-Str lctural Mechanical Insp Rain drain Insp
i-
Permittee Signature
Iss�ed By : L-�.z�- LEL-1�' � �--- g -
Call (:303) t39-4175 by 7-00 p.m. for an inspection needed the next business day
CITY "at IGARD Residential Building Permit Application Plan Check Recd Ry_ 6_1 �
13125W HALL BLVD. Additions or Alterations
Date Re:'d
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.
V 503-639-4171r ,o Date to DST 1 `' _
F 503-684-7297 `1' Permit# oLond •.��`r3
Print or Type - Called
Incomplete or illegible applications will not be accepted
- - - --- Name of► eject Name �-
�,, 4 w N f rL
Job O� / Architect Mailing Address
/address Site 4ddre _—
/a�/�,� SW GAr�.� ri� foM Q� City/State Zip Phone
- Na a
Owner Mailing Address
GG L� GAA 11141C-rvN OQ.
y-- ---L- —
FErigincer Mailing Address
Cit /State Zip hone _
71 L 472119 ort- q?z z y RNQ City/State Zip Phone
General Name ,I wYti r2 Sz;
Contractor 0 Oki"Cl Describe work New O Addition Alteration O Repair O
Mailing Address s i to be done _
Prior to permit Additional Description of Work:
issuance a cop City/State Lio Phone — —of all licenses
are requirod if Oregon — Exp. D___ate PROJECT _ y �
expired in GOT Lic# VALUATION $
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- ��_ N<< ,� Sq Ft. House: Sq. Ft, Garage
Contractor Mailing Addressth -
�Irldicate e restricted energy installation by the electrical
Prior to permit - - su tractor in the followin areas
issuance,a copy City/State Zip Phone Restnctdd Audio/stereo
or an iicenses _ __ _
are required if Oregon Const.Cont Board Exp Date Energy item /tfarms —
expired in COT Lic# Installations Vacuum Irrigation
database f+ siem Stem _
1:11Umbing Name � (check all that Other.•
Sub- (>c, nj —
Mailing Address -` Corner Lot YES NO (check
onto YES NO
Cont,actor (check one) _ ( ) _
_ Has the SubdiviSieh Plat recorded? N/A YES NO
Prior to permit City/State Zip Phone v -
issuance,a copy _
of all!1censes are Oregon Const Cont. Board Exp.Date _
required if Lic# I hearby acknowledge that I have read this application,that the
expired in COT _— -- information given is correct,that I am the owner or authorized agent
database Plumbing L!c # Exp.Date
of the owner, and that plans submitted are in compliance with
Ore State laws
- -�� Name r n ire of Ownei/A en Date
Electrical _ __-- _ Contact Per n Name Phone#
Sub Mailing Address ���ti)l,• /UL14lo,�f1�
Contractor _ _
City/State — Zip Phone --
Prior to permit i r
issuance a copy _ _ FOR OFFICE USE ONLY:
of all licenses are Oregon Const Cont Board Exp Date Plat# Map/Tl-#:
required if Lic#
Y
epired in COI ., — �— -��-- ---
database Electrical Lic " Exp Date Setbacks. Zonp� Solace
Eledtncal Supervisor Lic # Exp. Datee — Engineering Approval: Planning Approrel 1IF:
i\osts\forms\sfaddall doc 11120/99
M
S W LADY MARION DR.
elev 374' elev.374'
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Randy _
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684-9419(h) 245-1255(w)
10466 SW Lady Merlon Dr.
Marlon Fetata 9. lot 17 R-3 .5 zoning
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dandy �� ew3 7 Y"
Nurgari �`�P^n.q °• N*►nim
684-9419(h) 245-1255(w)
10466 SW Lady Marion Dr.
Marion Estate 9,Id 17 R-3 .5 zoni ig
Map _�0 c�y00
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private storm
easement i
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elev 262' line. � elev. 360'
Pcrn,it #: �JST_�cxx3-oc��l3_
OF
Address: O cv •_ ---
N z IssuLb �' � Date:'g
Ige39
Statement: Information Notice to Property Owners
About Construction Responsibilities
.Vote: 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 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. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. 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
All. I 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.
I hereby ctrtif.y that the above information is col-reci alld that I have read and du under.st;rnd the Information
Notice to Pro y Owners about (.'o •action Responsibilities on the reverse side of this form.
_ _ 2L--'p ,
Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
intotmal:xion Notice to Property Owners
About Gonstruc#ion Responsibilities
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