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Permit , . ^ • MASTER PERMIT — Cin»0�n PERMIT # : 91-0099 K�KCOMMUNITY DEVELOPMENT DEPARTMENT . ^ ^ ^ ~ ^ ^ ^ MST 9.1-0099 P.O. �oouornwn�.o�w� `.^ ^/ � — ' - 63941�71 �- -~ ~- DATE ISSUED: 05/29/91 • SITE ADDRESS...: 1E195 SW 121ST PARCEL: 2S103BB-0650@ SUBDIVISION....: ZONING: R-4.5 BLOCK ......."..: l~OT.............: — ---- BUILDING — — REISSUE: DWELLING UMITS:@ BASEMENT........:0 sf CLASS OF WORK.:ADD BEDRMS:69 BATHS:1 GARAGE'.........:240 sf TYPE OF USE...:SF _FLOOR AREAS- - REQUIRED SETBACKS---------- TYPE OF CONST.:5N FIRST....:0 ` \ sf LEFT..:99 ft RIGHT.:56 ft OCCUPANCY GRP:R3 SECOND...:0 sf . FRONT.:0 ft REAR..:0 ft STDRfES.......:1 THIRD....:0 1 sf REQUIRED ----- - HEIGHT........: 9 ft TOTAL------:0 sf SMOKE DETECTORS.: •FLOOR LOAD....:40 psf VALUE.....$: 4320 PARKING GPACES..:0 Remarks: ADDITION 240 SO FT SHOP , - - PLUMBING ----- -- ' �INKS...~......:0 FLOOR DRAINS....:0 BACKFLOW PREyNTRS..:0 LAVP|OqlES. . . . . :0 WATER HEATEB5. . . :Q) TRAPS. . . . . . . . . . . . . . :N TUB/S|<OWERS. . . . :0 LAUNDRY TRAYS. . . : 1 CATCH BPS INS. . . . . . . 10 WATER CLQSETS..:1 SEWER LINE (ft).:0 GREASE TRAPS.......:0 DISHWASHERS. . . . :0 WATER LINE (ft)0 :0 OTHER FIXTURES. . . . . :0 GARBAGE DISP...:0 RAIN DRAIN (ft).:0 WASHING SF RAIN DRAINS".:0 ' - MECHANICAL FEES FUEL TYPES----------- UNIT H?RS..:0 type amount by date recpt VENTS .....:0 BART $ 50.50 JLH 05/29/91 - MAX INPdT:0 BTU FANS..:0 BPLC $ 32^83 JLH 05/29/91 - ' FURN < 100K . . B�PC '$` -'� '2:53 JLH 05/29/91 - FURN )=100K ..:0 WOODSTOV—.:0 ' ' P5PC $ 1.25 JLH 05/29/91 - FLOOR FURN.-..80 CLO DRYERS.: 0 MART $ 19.00 JLH 05/29/91 - BOIL/CMP < 3HP:0 OTHER UKITS:0 MPLC $ 4.75 JLH 05/29/91 - GAS OUTL£TS:0 M5PC $ 0.95 JLH 05/29/91 - Owner: - PART $ 25.00 JLH 03/29/91 - PAT SMITH 12i95 SW 121ST AVE TIGARD OR 97223 Phone #: Contractor: - ---- THE GROUT CO 325 NW 21ST ST • PORTLAND CR • Phone #: 222-5654 Reg #..: 35451 ---- - - $ 136.81 TOTAL This peroit 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 Plumb Final applicable Lust U11 worjiIi h4done in awdance with approved Plm/undslab Insp Building Final plans, This peroit will expire if work is not started within 18N pLM/Underfloor Erosion Control eays of issoanco or if xorA is suspended for ome than 18N days. Plumb Top Out • Framing Insp Permittee Si.gnatura: � '� Insulation Insp Gyp Board lnsp I ssued By Rain drain Insp • � CAll for inspection — 639-4175 • • 1 25 SW Hall Blvd. PLNCK /RECT # �' �/ /%0Bilwv__ C ITY OF TIG) AR pO Box 23397 PERMIT # n757 / -oo 99 0, COMMUNITY DEVELOPMENT DEPARTMENT , Tigard, Oregon 97223 (503) 639 -4171 DATE ISSUED ' be . f C4, 2.5/ -3 al3 obsoo JOB ADDRESS: j2 t1' SW I TAX MAP /LOT 4 -i 3 ` 5 ZS SUB: A LOT: 6500 LAND USE: Pt keS VALUATION: " / -3 ' `l l � OWNER SPECIAL NOTES NAME: c -PkT IAVIH REISSUE OF: �5 � e ADDRESS 1' v `l-A S� 1Z P. �. LAST REISSUE: Il' eD4- _ FLOOD PLAIN/ PHONE: - SENSITIVE LAND: • CONTRACTOR `,�t APPROVALS REQUIRED NAME: -t\2. GAT Co PLANNING: ADDRESS: 3 )-5 t\\\JJ -21'5* ENGINEERING: FIRE DEPT: PHONE: 2. -2- .4( / OTHER: CONTR. BOARD #: -`.5 EXP DATE: /1 - /(D - g- )- ITEMS REQUIRED SUBCONTRACTORS: PLUMB: LIST /SUBCONTRACTORS: MECH: BUS TAX: ARCH /ENGINEER CALCULATIONS: NAME: _ �it ,e6 1 60(-- TRUSS DETAILS: ADDRESS: OTHER: PHONE: PROPOSED BLDG. USE: l (- 3 � � COMMENTS: i[1.� �0 i•► ..�i.:�� . - _ - • A -• N dt/P14iirt00 T iWa,tAJM( f tS Y o0M u 0 ' 1 � '�YY��`�� 7 .ate. 4 APPL. ANT SIGNATURE or Received By: C___ / " Date Received: __ S— 4/ PERMIT it. ACCT .# DESCRIPTION AMOUNT AMOUNT PD. BAL. UUE d0 rtlig 10 -432 00 Building Permit Fees 10 -431 00 Plumbing Permit Fees ✓ iS.d• 41.440 10 -431 01 Mechanical Permit Fees ./ If." gV . 4 i° 10 -230 01 State Building Tax (5 %) 413 r 3 . Building .2, 53 Plumbing /.2..f Mechanical • 95 10 -433 00 Plans Check Fee 5Y 37 Building 32. v3 Plumbing Mechanical 4,15 / 10 -230 06 Fire 30 -202 00 Sewer Connection 30 -444 00 Sewer Inspection 25- 448 -02 Commercial TIF Fees 25- 448 -04 Industrial TIF Fees 25- 448 -06 . Institutional TIF Fees 25- 448 -03 Office TIF Fees 25- 448 -01 Residential Traffic Fees 25- 448 -05 Mass Transit TIF Fees 52 -449 00 Parks System Dev Charge (PDC) 31 -450 00 Storm Drainage Syst Dev Chrg (SSDC) 24- 445 -01 Water Quality (Fee in lieu of) 24- 445 -02 Water Quantity (Fee in lieu of) • TOTAL 1344/ " ` ; r; . • , l X34,0; nm /3587P.WPF ti . a INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: �A v f/ 4-2r) � — Footing Plbg. Underalab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing diala Post /Beam Mech. Rain Drain Insulation - Plumb. Plbg. Underfloor G �� Water Line Gyp. Bd. -MM Date Requested: /J // � s � g,/ Time: 1. - - AM - PM lo Address:� �� /`7. 7 � / �Pe #: q/ Builder: THE FOLLOWING CORRECCTIIONS ARE REQUIRED: / r- G'arTe'L 0 1 1 » -tom J., o I4.c6 I ..;.cc Et (. Gcc -r,• nl / �,...(ia w=� (4(- 1- 0C6 i li j r. Inspector: / ' Date: c9 > 9/ • APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. l INSPECTION NOTICE `2/Z 7 City of Tigard Building Department ��j 13125 SW Hall Blvd. Tigard, Oregon 97223 v � Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: (")'- _ Footing Plbg. Underalab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation Plbg. Underfloor Water Line J Gyp. Bd. -Mech. Date Requested: ,/Q/15--- A y g( Time: X- AM PM Address: /� 5* r m3t / #: 9/ 669q Builder: i7•1 __ THE FOLLOWING CORRECTI S ARE REQUIRED: Inspector: � / � � (-2.-?le Date: i 6 / 64-- APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. 5/10/00 Activities for Case #: MST91 -00099 1:11:18 PM Assigned • Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By: Updated Notes MSTA007 Application received 5/24/91 JLH PASS BLT 5/28/91 MSTA020 Plan check by 5/28/91 RT PASS BLT 5/28/91 MSTA030 Check for prcl. restrict. 5/28/91 5/28/91 RT PASS BLT 5/28/91 MSTA705 Foot/found Insp 6/11/91 KS APP KBS 6/12/91 MSTA715 Plm /undslab Insp 6/27/91 MS PASS BLT 6/28/91 MSTA717 PLM /Underfloor 6/10/91 MS PASS BLT 6/11/91 MSTA722 Plumb Top Out 6/21/91 MS PASS BLT 6/24/91 MSTA725 Framing Insp 6/25/91 KS APP - KBS 6/26/91 MSTA797 Plumb Final 7/24/91 MS PASS BLT 7/24/91 MSTA799 Building Final 8/5/91 KS APP KBS 8/6/91 MSTA092 (F) Issue combination permit 5/29/91 JLH PASS JLH 5/29/91 MSTA007 Application received 5/24/91 JLH PASS BLT 5/28/91 MSTA020 Plan check by 5/28/91 RT PASS BLT 5/28/91 MSTA030 Check for prcl. restrict. 5/28/91 5/28/91 RT PASS BLT 5/28/91 MSTA705 Foot/found Insp 6/11/91 KS APP KBS 6/12/91 MSTA715 Plm /undslab Insp 6/27/91 MS PASS BLT 6/28/91 MSTA717 PLM /Underfloor 6/10/91 MS PASS BLT 6/11/91 MSTA722 Plumb Top Out 6/21/91 MS PASS BLT 6/24/91 MSTA725 Framing Insp 6/25/91 KS APP KBS 6/26/91 MSTA797 Plumb Final 7/24/91 MS PASS BLT 7/24/91 MSTA799 Building Final 8/5/91 . KS APP KBS 8/6/91 MSTA092 (F) Issue combination permit 5/29/91 JLH PASS JLH 5/29/91 • • • . Page 1 of 1