Permit CflYOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 MASTER PERMIT .
639 -4171
EXPIRED DATE ISSUED: 4 -0311
ISSUED: 08/09
PARCEL: 1S136CB -04700
SITE ADDRESS...: 10825 SW 83RD AVE
SUBDIVISION ° STEVE & HUGHIE'S PLACE ZONING: R-4.5
BLOCK LOT -19 •
BUILDING
REISSUE: DWELLING UNITS :1 BASEMENT °0 sf
CLASS OF WORK° :ADD BEDRMS :1 BATHS :0 GARAGE °0 sf
TYPE OF USE... :SF FLOOR AREAS REQUIRED SETBACKS
TYPE OF CONST. :5N FIRST -516 sf LEFT.. :8 ft RIGHT.: 5 ft
OCCUPANCY GRP. :R3 SECOND... :0 sf FRONT. :20 ft REAR.. :57 ft
STORIES °1 THIRD °0 sf REQUIRED
HEIGHT °16 ft TOTAL :516 sf SMOKE DETECTORS.:
' FLOOR LOAD °40 psf VALUE $ 33365 PARKING SPACES.. :0
Remarks: REMODEL AND BEDROOM ADDITION 516 SO FT PATH I
PLUMBING
SINKS °0 FLOOR DRAINS ° BACKFLOW PREVNTRS.. :0
LAVATORIES ° WATER HEATERS... :0 TRAPS °0
TUB /SHOWERS ° LAUNDRY TRAYS... :0 CATCH BASINS °0
' WATER CLOSETS.. :0 SEWER LINE (ft). :0 GREASE TRAPS °0
p DISHWASHERS °0 WATER LINE (ft). :0 OTHER FIXTURES . :0
GARBAGE DISP... :0 RAIN DRAIN (ft). :0
WASHING MACH... :0 SF RAIN DRAINS.. :0
MECHANICAL - --- FEES
FUEL TYPES UNIT HTRS.. :0 type amount by date recpt
VENTS :0 BPRT $ 211.00 KS 08/09/94 —
MAX INPUT :0 BTU VENT FANS.. :0 BPLC $ 137.15 JF 08/05/94 94- 255306
FURN < 100K .. :0 HOODS -0 BSPC $ 10.55 KS 08/09 /94 —
FURN > -100K .. :0 WOODSTOVES. :0 ERPC $ 8.45 KS 08/09/94 —
FLOOR FURN °0 CLO DRYERS.: 0 ERPC $ 8.45 KS 08/09/94. —
BOIL/CMP ( 3HP :0 OTHER UNITS :0 EROS $ 26.00 KS 08/09/94 —
GAS OUTLETS :0
Owner: --
CHARLES BROCKWAY
10825 SW 83RD •
TIGARD OR 97223
Phone #: 671 -5540
Contractor:
OWNER •
•
Phone #:
Reg #..: -- •
$ 401.60 TOTAL
This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS --
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot /found Insp Mechanical Final
applicable laws. All work will be done in accordance with approved Post /Beam Struct Building Final
plans. This permit will expire if work is not started within 180 Post /Beam Mechan Erosion Control
days of issuance, or if work is suspended for more than 180 da s. Mechanical Insp Crawl Drain
Framing Insp
Permittee Si ature: kgj & Insulation Insp
Gyp Board Insp
Issued By: Rain drain Insp
Call for inspection — 639 -4175
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-4 • Residential Building Permit Application , ,r(O
C i t y of T i g a r d \ , \ \ c % ce °`
13125 SW Hall Blvd. C ■
- ,
Tigard, OR 97223
(503) 639 -4171 zo ,,, t_/ 5-
/ Oazc. ' W 83
Jobsite Address: -- 7;51aps,
_ ;.:
Subdivision:5 4 I`JGy�i -r. V - Lot # (9 OfFice Use
Valuation: L Gf' , 5 r'v Planck/Rec
mit # ✓ f : //
Per
Corner Lot? Y C N
___--- .:: Reissue of
Flag Lot? Y c r___I 4-- ---- ---- ---- ,........... .:::.:::::: .. .. • ...:::.
Map & TL # / ." ,,l'r � •
Owner: CHAV ES i f{frluo/`r 10 y Approvals Required
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Address: 8 4 5 Plann'i ng � % % � �
77641Z0 , Ott °17LZ�
m� � ' Engmeerrng ::
Phone: f �lvl 65 - Other
w 67/ -6'540
s
Contractor: ) Items: Required :
Address: ........................ Subcontractors
Tru Details . ::;
Phone: :Other:;
Contractor's License # :
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Engineer:
Plumbing: Address:
Mechanical:
(attach copy of current OR Contractor's License)
Phone:
JOB DESCRIPTION: E9M - L. "' 5EDRD'oM �DOlTIOI� /6 0
il .► i4oMt 4f y3 J
Applicant Signature & Phone number
Received by: , + Date Received: 53 2- — g
--'/ N: \WORD \COMDEV) SAP
Permit # Account Description Amount Amt. Pd. Bal. Due
5/1(/-0 3/ I Bldg. Permit (BUILD) OZ u
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax
Bldg: 7th
Plumb:
Mech:
Plan Check (PLICK) / 37" / I 3 7,
Bldg: /37. 6 I
°7
L1.:17.L;f:
Plumb: ,Virt.,%.
„
Mech:
4 N
Sewer Connection (SWUSA)
r t "
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT) v
—
Erosion Planck/USA (ERPLAN) g';1/ • k",(../.
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•1„.
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Erosion Pla • (EkiSNP.M0'‘..s 3 , L ke, A
• TOTALS: ° • •/ 6 • Li