Permit CITYOFTIGARD MASTER PERMIT
IT # MST93 0448
COMMUNITY DEVELOPMENT D ►-R FMENT DATE ISSUED: 11/19/93
1125 §W Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S102BB -00500
SITE ADDRESS...: 10200 SW KATHERINE ST
SUBDIVISION . GREENBURG HEIGHTS ADDITION ZONING: R -4.5
BLOCK . LOT -15
BUILDING --
REISSUE: DWELLING UNITS :1 BASEMENT °0 sf
CLASS OF WORK. .NE raaIcl BEDRMS :2 BATHS :1 GARAGE :720 sf
TYPE OF USE... :SF FLOOR AREAS REQUIRED SETBACKS
TYPE OF CONST. :5N FIRST °490 sf LEFT.. :0 ft RIGHT. :8 ft
OCCUPANCY GRP.: R3 SECOND. :0 sf FRONT. :40 ft REAR.. :30 ft
STORIES— ...... :1 THIRD °0 sf REQUIRED
HEIGHT -14 ft TOTAL :490 sf SMOKE DETECTORS. :Y
FLOOR LOAD °40 psf VALUE $- 35500 PARKING SPACES.. :1
Remarks: ADDITION OF 490 SQ FT LIVING AREA AND 720 SQ FT GARAGE PATH I
- --- PLUMBING
SINKS -0 FLOOR DRAINS -0 BACKFLOW PREVNTRS.. :0
LAVATORIES -1 WATER HEATERS... :0 TRAPS •0
TUB /SHOWERS "1 LAUNDRY TRAYS... :0 CATCH BASINS •0
WATER CLOSETS.. :1 SEWER LINE (ft). :0 GREASE TRAPS °0
DISHWASHERS -0 WATER LINE (ft). :0 OTHER FIXTURES -0
GARBAGE DISP... :0 RAIN DRAIN (ft). :0
WASHING MACH... :0 SF RAIN DRAINS.. :1
MECHANICAL FEES
FUEL TYPES • - -- UNIT HTRS.. :0 type amount by date recpt
/GAS/ / / VENTS ..... :4 BPRT $ 220.00 JH 11/19/93 —
MAX INPUT :O BTU VENT FANS.. :0 BPLC $ 143.00 JH 11/19/93 —
FURN < 100K .. :0 HOODS -0 B5PC $ 11.00 JH 11/19/93 —
FURN >=100K .. :0 WOODSTOVES. :0 MPRT $ 28.00 JH 11/19/93 —
FLOOR FURN— .. :0 CLO DRYERS.: 0 MPLC $ 7.00 JH 11/19/93 —
BOIL/CMP ( 3HP :0 OTHER UNITS :0 M5PC $ 1.40 JH 11/19/93 —
GAS OUTLETS :0 PPRT $ 37.50 JH 11/19/93 —
Owner: PSPC $ 1.88 JH 11/19/93 —
KENNETH TOLLIVER
12375 SW 13TH ST
BEAVERTON OR 97005
Phone #: 643 -9215
Contractor:
OWNER
Phone is
Reg #..: 00000
$ 449.78 TOTAL ,
This pereit 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 Gyp Board Insp
applicable laws. All work will be done in accordance with approved Post /Beam Struct Rain drain Insp
plans. This permit will expire if work is not started within 180 Post /Beam Mechan Mechanical Final
days of issuance, or if work is suspended for sore than 180 days. PLM /Underfloor Plumb Final
Mechanical Insp Building Final
Permittee Signature: i ) _ Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Issued By: Insulation Insp
Call for inspection — 639 -4175
CITY OF TIGARD 13125 SW 143u Blvd. PLNCK /RECT #
Tp�cd.Orcgon9T2I3 PERMIT # �'1'i5( / - U C(fy
COMMUNITY DEVELOPMENT DEPARTMENT
(503) 639-4171 DATE ISSUED
JOB ADDRESS: /642 Ud 54, / k.e0 -(.: - - TAX MAP /LOT S7 a�-fa --005 v
SUB: 67efen 6w.- 1 r r 9 'l/r, A-( LOT: (5 LAND USE:
VALUATION:
OWNER SPECIAL NOTES
- r
NAME: (reivi-er( ,d( /Ci4 REISSUE OF:
ADDRESS: ( 7 r Jr /3 LAST REISSUE:
FLOOD PLAIN/
PHONE: _� 9 �� — a' 7 , O SENSITIVE LAND:
CONTRACTOR 14 APPROVALS REQUIRED
NAME: �} vi Ai Imo`'" PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: - OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED `
• SUBCONTRACTORS: PLUMB: LIST /SUBCONTRACTORS: /VPecf°
MECH: - BUS TAX: -
ARCH /ENGINEER CALCULATIONS:
NAME: :: TRUSS 0 TAILS:
/
ADDRESS: • OTHER: k e 1 A f'
f rIA,c1,
PHONE:
PROPOSED BLDG. USE: Foil h Ai. w a49.1° /i.f 9 /44'
COMMENTS
APPLICANT SIGNATURE
Received By: Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
Alf 10 -432 00 Building Permit Fees AU
10 -431 00 Plumbing Permit Fees 37,J'r'
10 -431 01 Mechanical Permit Fees 0,2rSYrtlw / d'-icre
10 -230 01 State Building Tax (5 %) PAZ
Building / /, ='°
Plumbing /4
Mechanical f, q U /
10 -433 00 Plans Check Fee / /CV
Building /
Plumbing
Mechanical 7,47 /
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 • 7 W99. 7r
nm /3587P.WPF
• (3g4m
CITY OF TIGARD BUILDING INSPECTION DIVISION
,e3/ii } 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Ale, //e -e
'!r /
Date Requested: J %. -) O I �/" y"
' - / C A.M. P.M. MST: ) —
. Location: / 0 , 1/414 h nL4t , f, go /77 P: 73 - a
Tenant: �� �� /� j� Suite: Bldg: Bldg: MEC:
����
Contractor: f`-(%J"l _ C ,- bdt `e,�� Phone: L'0 H p t PLM:
Owner: Phone: ELC:
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onl t.. i 'Ih1 e 7 4a- tL \ ELR:
r---Se, - L 4. 11'la da ,/vIS 3 — O t a) SIT:
BUILDING <BIAG (con't) \- PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
r
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
' <l Masonry Ceiling Rain Drain A/C . . UG.Slab..
Shear /Sheath Fire • Crawl/Found Dr . - Heat Pump Low Volt
� oved ' Approved ; a Approved Approved Approved
Appr /Sdwlk , ...'�pr ved Not Approved f' Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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0 Call for reinspectio 0 / .einspection fee of $ required before next inspection 0 Unable to inspect
Inspector: � , j Date: 6)/ � .-/ W Page of
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