Permit . . .
: 0..
CITY OF TIGA ., i
. 1
DEVELOPMENT SERVICES " , `'� ' R ERMI EC' ICiN
. .; ,� 'ERi�1IT
' _ °-U- - 'LL ` ' 13 125SWthatEtyd „flgard,,OR87223,(503)639.4171 .PERMIT ' = S!WR�. ,A= O3G
” . DATE ISSUED: 03/10/98
. . PARCEL: ES 1 1 1 DA -01700
SITE ADDRESS.... k08624 SW LODI LN .
SUT3D I V I S I Oi' .... r APPLEWOOD PARK NO. 1 ZONING: R -7 PD .
BLOCK:.....,.;... LOT II Is a an . .. i0i3 JURISDICTION: TIE ,
T EN'ANT NAME........ - o LEGEND HgMES . . ' , • • , , - .
USA NO. • . F TWITS.. , a O. '
, CLASS OF WORK... :NEW,,. • . _ DWELLING UNITS.:,: 1' ' ,
TYPE C)F. USE..•,.. ; :SF NO. CF BUILDINGS: . ' 1 .
INSTALL TYPE,. P :.: BUSWR , ' I MPERV• SURFACE : 0 sf • ' "' ' ' • , 'Rema'rks: SF — Path 1 „ I . , . " „
' Owner: • „ -- - -' - -- u' — -- •
, LEGEND HOMES' . , type.. . ` 'key, °dates r
6900 SW' HA I NES ST ' PRMT ,S' 2200. 00 DLH . 03/10/98 98- 303971
(" I GPRD OR 97223 INSP ?, 35. 00 , DL.H_( 03/ 10 /S8' 98-30397,1 „ '
•
•Phone *: - - - • - Contract me -- - ----- - -'- - - ^ —° _ - - --- - _ _
• OWNER . •
Phan a It•. . • ' - - ' • $, 1: `235. 00 TOTAL • ,
„ • , - - - - -.- — . REQU I RED I NSPECT I bNS —,_ - -.__— ' ,
This A pplicant agrees to coaply with ell. the rules and regulations Sewer Inspect i. on ' .
' 'of the Unified Serage Agency. The pereit expires 1.80 days fron ' ,
the date ,issued... The total aoount paid:1'iil be forfeited if the _.__._ _
' pereit' expires. The ,agency„ does not guarantee the accuracy' of the' „ _ _
side ser laterals. •'If the sewer 'is. not located the neasureeent ' , , '
e _ _
given, the •insta' shall prospect 3 feet in all directions froo , . _ "
'
the distance given. If not, so located the install"er 'shall purchase ' -____ _!_ _
a 'Tap and Side Sewer'" pereit and the Agency-will install a lateral. , - ,
ATTENTION: 'Oregon law requires you"to follow rules by the ' . ' _._ _ _
Oregon Utility 'Notification Center.; Those rules are set forth in''DAR' . . • - _._ _'
, 952-421-681C/ 'through-DO 952-0014M 080. You oay obtain copies of • . _ _
these rules or direct questions to OUNC by calling M3)2464987. , _ _ _�� • ' •
I ,saga by , ___. �_,_ 'er tee '$ignat�,r _ __�.
•.1--14-1- + + + + +ti-++ • + + ++ +++ i +-F -F -1-+ -++-1-4- f is-t + + ++-t -!• •1-4 -4- I-+ +-1- F -h- 1-= l- +. -+ 4 + + + + +-I-+*- 14+•F•f4++++••F+ 1-; ir4.4 4- •
' Call •639 -417 5, ,by 7:00 p.m. r nor an inspect•ibn ner'eded the next. business day ,,%. ,
• +- 'r;-F-F-{--F- i- +-6•i- F+•• •+- •i•r- F+- 1- +'-'r+ + +++ ++•- ++F{ -•L+•I F_F + +-1- +++++++++1-+++4++-14-4-4-1 . ;
•
Plan Check #p?- 342
CITY OF TIGARD Residential Building Permit Application Recd By - --- O
1312.5 SW HALL BLVD. New Construction Additions or Alterations Date Recd _ % - ,
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. _ �[
V 503- 639 -4171 Date to DST 3-3-9
F 503 -684 -7297 Permit # 'V �� -/ S Flg -
Print or Type Called /3O
Incomplete or illegible applications will not be accepted
•
Nre of Project PalA We Job 1''J�/04 13 Il� r�rh.P�
/ Architect Maili Address
Address site , s c l n . C . 6790C- - ) Li p c".
te e a Z .) to Loa = - :0 "` City/State . Phone /,�
Nagle ,/ .-t OR • 2 .33 (020 - ICD c1.0
'Le /9/A4a S Na �
Owner Maili Address FO D`le Q , :. : •
` "- Engineer Mailing Address .
,,
State Zip P hon • Coq CO
- y1 OI' • C 1 - 7223 C ac� S o Cit .. .. P hone
General Nam''
OW. q 7223 C ep - ?�5
Contractor L ,e.p/ / ,as D escribe work ew Addition on O Alteration 0 . Repair 0
MailintAAddress - to be done: , , •
Prior to permit ' . 1(690 frj a .: _ • . _ Additional Description of W ork: : , • .
issuance, a copy City /State • Zip Phone :.n;
of all licenses "- t'Ckr 4 ()9 - Cf 71 6z o A 0 556 <.:
are required if Ore Const. Cont. Board Exp. Date PROJECT .
expired in COT Lic.# _ VALUATION / .:•.) � / :' . t/ ' " "'
database / 00 5 13 '':: '
Mechanical Name NEW CONSTRUCTION ONLY: '', - •
Sub- - 3V rTL.,) . \ne_ , Sq. Ft. House: L . _ Sq. Ft G arage •
Contractor
Mailing Add / ; / ' :. .: - / / - .
Prior to permit 2.412.n 5C- � O S Corner Lot Y S NO Flag Lot YES
issuance, a copy City /State Zip Phone- (check one) .. • - (check one) . • .
of all licenses For -i gn.ICo a5 3 "" 7RM Restricted "` Audio /Stereo Burglar
are required if Oregon,ConstCont. Board Exp. Date Energy : • System Alarm
expired in COT . Lic.#
database `II 1 3 5- 3G '9$ I � /L Garage Door
r g
HVAC
�
Plumbing Name '•.' B on Opener Systems
Sub - � c 1 cr l o m t'r1Q (check all that Other.
Contractor Mailing Address � ` . _) apply)
P O 601( Will the electrical subcontractor wire for all . Y5 NO
20 -• restricted energy installations?
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A Y S NO
issuance, a copy Ci c6,4,1- ,r,,,,,,., 4 q- Cd�7 _slily' I
of all licenses are Oregon Const. Cont. Board Exp. Date iN '
required if Lic.# - Reissue of MST #: Solar Compliance
expired in COT .2. 3 d9 G/ i I O : (9 -9 Z (Calculation Attached)
database Plumbing Lic. # Exp. Date I Nearby acknowledge that I have read this application, that the
4 .20ij 4 °6 - -9% information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Electrical C,--7 cm - h 2„r . c_ Sign tureofOwn r /A t - Date �,
Sub- Mailing Address / � p �0/ 4, oZ .a 2i1
Contractor Z 146 r- 5 (,v Tv tt't°\h. Jc j Contact' Person Na . Phone, ,
City /State Zip Ph brti e � `
Prior to permit , FOR OFFICE USE ONLY: .
issuance, a copy A-t dr (3Y. C1-.100G) Sq I — c - e� Plat #: Map/TL #:
of all licenses are Oregon Cost. Cont. Board Exp. Date 1 19 - ?j 1 Z j7 - 2 S I 11
required if Lic.# S
et C or:�
expired in COT I�^]2 c6*- ' 1 a -R�' � � fk
P� 3 1- a ! To 14
database Electrical Lic. # Exp. Date - •
Y1 J3O5 c n nearing Approval: Planning Approval: F:
I:SFREM.DOC (DST) 4/97
I
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