Case File ADDRESS .
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i s\rF cords\microflm\targets\building.doc
I CERTIFICATE OF
CITYOF TIGARD PLRM1T #. . . F'. . .. OI5T'93-0221
COMMUNITY DEVELOPMENT DEFAMMENT DATE: ISSUED! 09/27/93
13125 SW Mall Blvd "i,jard,Qraoon 97223.8198 (503)639-4171
PARCEL-s 'I S 1;34CB-- .l 4700
E31 T r_ ADDRESS. , . c 1,s_199 SW ANTON DR
SUBDIVISION. . — I AN-TON NARK II 'LONINGtR-7 PD
bI_aCK. . . . . . . . . . s LOT. . * . . . . . . . . * . t074
(:L.fa��3wGF'' WONh. sNEW ...._W._..._-___-_.__.__._____f_..__ ._._.._
-_.__._ __._...._ __._._� ...._._..__.
TYPE: OF USE. . . G Sf I�
OCCUPANCY GRP. a R3 l
OCCUPANCY L OPD#222 4
'1ENONT NC)HE. . .
Ri+mar k a t BATH E
D E ANDERSON INC
4525 SW 96T1-1 AVE
i
BE"AVENTON OR 97005
Phone #: 627--9999
C ontract or!
l) ANDERSON, INC
4575 SSW TUCKER AVE:
! i1EAVERT"IN OR 97005
Phone M& 627-9999
` Reg *6 . 1 46 344
Occupancy of the above referenced bklilding is hereb,+ given, and certifies
the compliance with the State Of Oregon Specialty Codes for the 91r,01ap,
occupancy, and t1se under which the referenced per it was i'asued.
i
f,L.D - INSPEC,OR
j UI D N5O-FICIAL.
POST IN CONSPICUOUS PLACE-.'
i
1
r
INSPEI'TION NOTICR
City of Tigard Building Departaent_
13125 ON Hall Blvd. Tigard, Orwmgon 97223
Inspect�Linr. (Rec-o-Phone): 639-4175 Busina_ee Phone: 639-4171
Inspection:_ ---
Footing Plbg. Underslab Hoch. Rough-in Appr./Sdwlk
Round. Plbg. Top Out Gas LineIFINNALs, i
Poat/Beam Struct. San. Sewer Framing -Aldg.
Post/Ream Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water LineGyp. Bd.
Date Reguestedr 1 _2_4=/�iyg—j__
—Time= —AN —PH
Addraes: Z 5J'47_�/�,. r Permit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
--k
A -�
Inspector. ''_ Datem_ —
-APPROVED" 3JIYPRQST+?n APPROVED SUBJECT TO ABOVE
For Rcinep.
fA
IL4P3CT10N._N2MqV-
city of 'Tigard assli.dinq Departaant
13125 M Hall 81vd. 'T1.gard, Oregon 97223
Inspection Line (Rec-O-Phunu)c 639,4175 Business Phones 639-4171
Inspections 1V\
F4otinq P1bg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line IIfALt
Post/Sc +m Struct. San. Sewr:r Framing -Bldg
Post/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor
Water Linty Gyp. Rd. -INO1t• /
Date Reyusetedt G I i-� Timet S!1 —2L(PN
Addreeus l�-� ! f\V\; � Permit f s ��( �1� 021�L
Builders �\�1DdlA�kAx^OOV-
THE FOLLMIINO CORRECTIONS ARE REQUIRSDs
c-e ss. �- �rS ...\
9,�3-� s
Inspectors_ _ Dates-
AP
atesAPPROVD DISAPP�6NED APPWW1D SU&TRCt TO MKPM
11 For Rainsp.
. C�
City of Tigard Building Daparf'e�tt
13125 SW Nall Bled._ Tigard, Oregon 97223
Xnapection Line 'Roe-O-Phone)t 639-4.'75 Business Phone: 639--4171
Inspections_ VI
Footing Plbg. Underslab Nech. hough-in Appr,iS:dwlk
Pound. Plbg. Top out Gas Line
Post./Beam Struct. San. Sewer Framing /s
Post/Beam Hoch. Rain Drain Insulation �Mltl�b.
Plbg. Underfloor WaaterLine ) Gyp. Bd. -Nub.
/
Date Requasteds -Z-2 / _ _.___Times
Address: l (` r� {1.�7�Cj��`u1( _ __ 1 Permit #I (051 q
Bui).der:
TNTC FOLLOWING COttRECfIONS ARE "WIFICM
Inspector: �` Date
APPROVED DISAPPROVED __ APPROVED SUBJECT To ABOVE
�\1�411 For Rainsp.
IgM p8C!'IOM Narzcs [ra
Cltt of Tigard Building Department
131125 M Ball Blvd. Tigard, Oregon 97223
rnsper.tton Lino (ROC-O-Phone)e 639-4175 Rusineaa Phone, 639-4171
Inapectionr___
Footing Plbg. Urtderslab Mech. Rough-in APP=/Bftlk
Found. Plbq. Top Out. Gas Line PIMALt
Posit/Beam Struct. Ban. Sewer Framing
Post/Beam Mff-h• Main Drain Insulation _Plumb,
Plbg. Underfloor Hater Lin* Gyp. ad. �KeDh.
Date Requested,_
Aadr..., /1Znl°1G) Ak lcn � f ,jP.ecait tM-IlpC`13
Buildarr_�. L� r�[l3F-
THU FOLLOWIWO •IOM? EEQUIRSD: �� 'r Z
O1TG a� a
IS
8 N e Qom. —�
Ins — 3
Inspec-tor: / /_ _ Detee
APPROVED V"'DISAPPRM/ED APPROvzD SUBJECT TO ABMR
For Reinsp.
INSPECTION NOTICE:
City of Tigard Building Departannt
13125 Sp Ball B1M. Tigard, Oregon 97223
Inspection Line (Ree-O-Phonn): 639-4175 Buaineas Phone: 639--4171
Inspection:
Footing Plbg. Underslab Neth. Ro;:gh-in Appr/Sdwlk
Found. Plbg. Top Mt Gan Line CNA
Poet/Beam struct. San. Sewer Framing cld3
Poet/Berm Mech. Rain Drain Ine lation -Plumb.
Plbq. Underfloir Nater Line Gyp. Bd. ech.
Date Requested: --Time j __—AM _ PM
Addreass� �� .� v� Permit #:13- 62—z_
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ` '
Ln-
InspLctor:^ Dates
r7
APPROVED _� DISAPPROVED APPROVED SUBJECT TO ABOVE
__- Call For Relnep.
_NSF UMN POTICE /41-1j
Cita of Tigard Building Deia+-f •t
13125 SR Hall Blvd. Tigard, Orogon 97223
Inspection Line (Roc-O-Phone): 639-4175 Businos■ Phones 639-4171
Inspection:
Footing Plbg. onderala3 Mach. Rough-in Appr/Bdwl)-
Found. Plbg. Top out Oar Line ( FEKALt l
Poet/Beam Struct. San. Rower Framing -Bldg.
_4
Post/Born Mach. Rain Drain Insulation }l�
Plbg. Underfloor Mater Lin* Gyp. Rd. -Meeh,
Date Requestedt 2 '1 - 1Time:
� 1
Address:1,ZI ` / (,,ti� Permit
Builder: Nk(( �DCXJ t/V 00�_ (8-7
TM FOLIAbING JORRECTIONS ARE RRGUIRRD:
Inspector Date:
APPROVRD DISAPPROVED APPROVED sUBJBCT TD ABGVS
Call For Reinap.
INSPECTION MaTiCS
City or Tigard Building Department
1312S SW Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)i 639-4175 Business Phone: 639-4171
Inspect tone_
Footing Pl.bg. Underelab Mach. Rough-iq a/tldMlk 1
Found. Plbg. Top Out Gas Line IINALe
Post/Beam Struct. San. flower Framing -Bldg.
Past/B,lm Mach. Raln Drain Insulation -ply.
P)!.g. Underfloor NQator7�Line Gyp. Rd. -Hoch.
Date Requested t p �Lp _Gt%
Q p Tines AN pK
Addrewst_ 1 2-( l l Ay,-� � Permit #s
Builder:-Lv14AL6AJ 600L 1XV W 5`0
THE FOLLOWING CORRECTIONS ARE PMUIREDt
i
Pef,-(?4e Nisi-4
Inspectort.- O1w-Gts _ Dates�_-�� —
APPROVED DISAPPROVED --- ' XpPROVED SUBJECT To AaIM
Call For Reinsp.
,4"jgj"ffl 1#0TICE Nu
City of Tigard Building Departaexrt
13125 811' EL-111 Blvd. Tigard, Oregon 93223
Inspection Line (Rea-O-Phone): 639-4175 Businena Phones 639-4111.
Inepnctionx Ct:� e' i'-v� ---- -
Footing Plbg. Underelab Mach. Rough-in Appr/Siwlk
Found. Plbg. Top Out aas Line FINALt
Poet/se'+m 31 ri.ut. San. Bower Frcming -Bldg.
Post/Beam Mach. Rain Drain insulation -Plumb.
Plbg. 11�deriloor 11ter Line - Opp. lldl -lteoh.
- _
Date Requestedx [� _ __�Tle1e1 q AM !M 1
Addreen: -I' �' �1/�tC7Y� -- Pormit #$ 1?�"62
Builder: .
1
THE FOE.I.ONINO CDRRaCT1of8 ARE RE(N"RRDx
Inspectors Date$ f /�
APPWM DIBAPPRO'VRD APPROVED SUBJUCT To ABOVE
`Grj/ G)1 For Reinep.
3��cr�pce�+oTi�
City of Tigard Building Department \N
13125 aN Ball Blvd. Tiqard, Oregon 97223 V
Inspection Lina (Rec-O-Phons)s 639-4175 Business Fhona: 639-4171
Inspections
Pcwting Plbg. Underslab Mach. Rough-in APer/Sdwik
Pound. Plbg. Top Out Gas Line FINALS
Post/Buem Struct. Sen. sewer Framing -Bldg.
Post./Beam Mach. Rein Drain Insulation -Plumb.
Plbq, Underfloor /}"ater Line -Mach.
Data Requeste/ddss v_ Sims _,t AyM __PM
Addr•as t �Z 1 1 \ �}le/rm/it #s ✓ c�G 2
Builders H _�- -L.,[.�l,V{�s (b�
TRE FOLLOWING COMMONS ARE RBQUIRRDs
inspector-_ �., : � �-1�'� Dates
APlBO�IBD DI8APPPRovBD "Prom BOwom To AMM
KI - k call For Reinsp.
INBFaCTION NoTICS
City of Tigard Building Departasnt
13125 BR Ball Bled. Tigard, Oregon 97223
Inspection Lina (Rec-O-Phone)t 639-4175 8116inese Phone: 639-4171
i
Inapoction,k/V
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Ciao Line FINALt
Posy./Beam Dtruct. San. Sewer Framing 1 -Bldg.
Post/Beam Mach. Rain Drain Insulation -plumb.
Plbg. Underfloor water Line Gyp. Rd. -Mach.
Data Requestedt 2 /'—_!17�1 _ Times A.M,( pN
Address, �J`7-�//�/—/�.CJ, Permit if''1 /_i Z
Builder, _'►as
TB= F'OLLOIIING OORRECTI ! ARS P1WtRFJt
�-� 1
InspectoZAPPWVM
'/ r��- DotalZ--1
�_.
DISAPPKOVED APPRCPMD S"BJRV-T To a9MM
__Call For Reinop.
zhsracTzot, o Hca
City r Tigard Building Depertaant
13:LYS M Hall Blvd. Tigard, Or"M 9722-
rt ne?•etion Line 14sc-aPhon• a 639._{175 Busin•e• Phrnei 639-4171
root P bq. D'nd•re!!ab
/f� h- ROagh-in Appr./sdwlk
Tounu. plbg. ' (v Out./ `�
Gas Line rIMALr
Poy /Beim et r ct. San. erwwr c9m nq- -Bldg.
Poet/seam !{oc h. /
Rain Drain Insulation -Ply.
Plbj. Underfloor Mater Line Gyp. Bd.
� -Mach. /
Pits Requeetod: zJ� __Timms
: 1
Address ��
P.reit A s
Builder /
TRZ I'OLLONING OORUCTIORB ARE RXMIREDs
Ea
Inepecl:ors
T Dat
_"PPAOVQD r
Y� DIISAPPROVED _� APPROVED BtlBJECT TO ABOVE
Call For Reinep.
")'ECTION NOTICE
city of Tigard Duildiaq Departaent
7.3125 SN Rall Blvd. Tigard, Oregon 97223 ha
Inspection Line (Rec-O-Phon )e 639-4175 Business Phone+ 639-4171
Inspections_
t — —
tootinq Plbg. Uf.derslab h. Rough-isr) hppr/Sdwlk
Found. Plbg. Top Out Cas Line lINALt
Point/seam Struct, San. Saver t I►reminq -Bldg.
Post/Beam Hoch. Rain Drain Insulation --Plumb.
Plbg. Underfloor Nater :ine Gyp. Bd. -Hach.
Date Requesteds —_L —Timet AH _PH
AOdres:s / 1_ Permit l 2-
Builders.Builders_
TBE /OI.I.ONIMO CORRZCTIONB ARE RWJIREDt
Inspectors`— VIC
�-�� Datat__
APPROVED _- DISAPPAOVED --- APPROVED SUBJECT To ABO"!
�� __call !or Reinsp.
IRSPECTion WJTICE
City or Tigard Building Departaont
13123 Bw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phono)t 639-4175 Business Phones 639-4171
Inspection:
Tooting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FIMALt
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line gyp. Rd. -Koch.
Date Requestodt Time: AM _PK
Addresst 1qqJ.`�' `_ '✓ Permit ir9 I
3 �
Builders _
THE FOLLOWING CORRECTIONS ARE REQUIRED t C,
Inapectort_ '�(/ Dates_ 1`'1
--APPROVED DISAPPROVED _ V APPROVSn SUBJECT To ABOVE
—`,Call For Roinsp.
i
, .-.+-•�....i M a,M.1"..w o•-r n.•r•rnr...r>.+esi Hr.ww•r+fir a.Ir,n..+ . y,.. �.r.....-
City of Tigard vhzil.A"q Deparkaraat
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Hoc-o-Phonalf 639-4175 Business Phonal 639-4171
Inspections
Footing Plbg. Underalab 6}i. Rough-in Appr/Sdwlk
round. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. Ban. Swwer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lina Gyp. Rd. -Hoch.
Data Requested -` Time: _ AN _ fM
Address i Permit
Builder:
TBE FOLLOWING CORRECTIONS ARE RZQUIREDt
Inspectors Data r '
APPROVED DISAPPROVED APPROVED BUBJECr To ABOVE
CA11 For Reinsp.
�SpECTIOn narIg
City of Tigard Building Depertesnt
11125 SW Ball Blvd. Tigard, Oregon 97223
Inapection Line (Roc--o-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Hech. Rough-in Appr/Sdwlk
round. Pl .
�bg Top out Can Lino lINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Bld 4
Post/Beam Hoch. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Lino Gyp. Bd. -Hoch.
Date Requestodc2_ / ,:3 —Times -41 AM _PN
Address: 1 jL21A( _--_ Permit
Builder:
TBE 1"OLd OMING CORRECTIONS ARE REQUIRED:
I
I
— — i
Inspector:�`—�- Dates-1
.)L--APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVR
---Call For Rsinsp.
Citi of Tigard Building Department
13125 Sq Ball Blvd. Tigard, Oregon 97223
Inspection Line (Reel-Phone(: 639-417, Business Phones 639-4111
Inspections
Footing Plbg. Undernlab Mach. Rough-in Appr/Sdwlk
Found. Pi -Top Out Gas Line FINALs
Post/Beam Struat. Ian. fewer ) Framing -Bldg.
Post/Beam Meeh. Main Drain Insulation -Plumb.
Plbg. Underfloor ter Litte Gyp. Sd. -Hoch. J7u/c L
Data Requestedt v `Timet _ AM PM
Addrosss7 1pC � � Permit t, Y:
Builder:
THi FOMMING CORRECTIONS ARE REQUIRED:
Inspectore� _ Date:
`L APPBOVBD DISAPPROVUD APPFA M=D SUB31M TO AJKM
Call For Reinsp.
�NgPB,gTION ff=IGi
City of Tigard Building Departaent
13126 " Hall Blvd. Tigard, Oregon 97223
Inspection Lina (Rea-o-Phone)s 639-4175 Business Phones 639-4171
Inspectlons_ _
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINA'.s
Rost/Beam Struct. San. Sewer Framing -Bldg.
Post/Mas Mach. Rain Drain InsulaO.on -Plumb.
4-
Mg. Underfloor Mater Line Gyp. Bd. -fib• �//
Date Requesteds Times AM
llddresss +�=`� 7� r�,� -rte 7C..-' Permit is
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
n_ 5)
inspector:__ _--
APPROVED DISAPFROVRD APPROVED SUBJECT TO ABOVE
Call For Reinnp.
City of Tigaid Building Departaent
13125 Sw Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Roc-O-Phc )s 639•-4175 Bualness Phones 639-4171
Inspections_—�
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
round. Ptbg. Top Out gas Line FINAL:
Past/Baas Struct. San. Sewer F.vsminq -Bldg.
t/Seem Nsoh. Rain Drain Ineslation -plumb.
tibg. Underfloor / Nater Line gyp. Bd. -Mech.
Data Requested: I( `7 '/� _TLmes
Addreees Z- , � 1� ��.�Z� � Permit is
Builders //-
TBF rOLLMINO CORRECTIONS ARE RNMIREDs
Innpectors
vr—�- 1—Z-�-- Dates�� i' L
APNkCIRD __ DISAPPROVED APPROVED su"cT TO ABOVE
___Call For Reinep.
Cit? of 2i.gasI Building Department
13125 = Balk nivd.. TJ94rd, Oregon 97223
'J"r Inspection Line (Rec-O-Phone), 639-4175 Business Phone, 639-4171
Inspection,
r>—
!!t
a--- -- - -
Iooti
P.Lbq. Underslab Meth. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Line FINAL,
Past/Ream struct. Ban. Sw4er Training -Bldg.
Post/Baam Meol,. Rain Drain Insulation pluTh.
Plhg. Underfloor //Water LineGyp. ad. -M h.
Date Regneste -d, to /L�J 3 Time, AJ4 pM
Address,_ !`7Z L��/ Permit
Builder,
TBZ FOLD MING CORRECTIONS ARE REQUIRED,
Inspector,
Date,
/'-�APPROVED Dis"PROVED APPROVED SUBJECT TO ABOVE
--.,—Call For Rafnep.
MAG'fER PERMIT
CITY OF TIGARS► FERMI T 14. . . . . . .
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. ovird,Orog-)n 97223*6199 (603)639-4171 DATE ISSULD: 06/01/'j-
- ' iE . 12191) :W ANIUN Ok PARCEL& IS1,14L1:►-1471,
SUBD I V.151 ON. . . . : ANION PARK 1I ZUNINGi R-7 PD
OLUCV,.. . . . . . . . . . . LUT.. . . . . . . . . . . . . :074
BUILDING
T.,,"I ss uE s ms T-9 o 16 6 UWU-.LL I NG UN 1 T IS:; I BASEMENT. . . . . . . . :Ili 9
(.:LASG OP WORE. :NEW BEDRMS:3 PATHS,l; GARAGE. . . . . . . . . . .446 S
UF U6L. t;;F FLOOR AREA " - ---- R1--UU1kLD L3ETbr-)CR6, -- -
YYPE OF CONSI . jLIN F*I RST. . . . : 740 s f LEFT-5 ft RIUHO' . -5 f t;
'i ft REAR. . t�!.O f t
U!�;[.'-UPANCY GRP. -R3 '-,L�CVIND. — 1-660 f FRONT.
ST'GRIES. . . . . . . :C.' THIRD. . . :0 Sf REIDUIRED------ -
HEIGHT. . . . . . . . AZE ft ILI I AL-- -- . .� I
-too sf 'SMOKE DETECTORS. :Y
I LUOR LOAD. . . :40 psf VALUL. . . . . $: 1:.42a PARKING SPACES— : 1
kemarli-, : PAT'll S
PLUMU
i-*1 y i ill's. . . . . . . . . . . I FLUOR DRAINS. . . BAC1,10"LOW PRL"Y'N 1141-1 0
AVA,l OR I Es. !3 WA.'E R HEA I ERS. . . 1 TRAPS- - & . . . . . v - . :0
L113/51-11OWURS, LAUNDRY i RAYS. . VI CATCH ]BASINS. . . . . . . .0
WA 1 1�111 CLOSE` 6. . -3 SEWER LINE (ft ) . :0 GREASE 'TRAPS. . . . . . . .0
WATl--R LLNE. ( ft ) . : 1o 0 THLR F I X TURL*tj. . . 0
�41RBAJE buw. . . c RAIN DRAIN (ft ) . :0
WN:AAJANIG �31- liqlN MOMS— : 1
f CILi
Uh,L tYPL..'.; UNIT w,rze. . tO type :41"01.4tit by date
bAE;l VENTS . . . . . :0 TIF $ 1460. 00 JH 06/01/93
Mox '11-41PUT:01 BTU VL--Nl' 1"ANG. . -4 DPRI, $ . 5c.'. 00 JI-i ot./01 4-,)j
URN 100K ; I HOUDG. . . . . . . bPLL $ 40. 00 .ILII 04114/93 93--L.
I UPKI i -I QAdK 0 W01JUSI-OVEL-3. -.0 P-5 P C 17. 60 JH 06/01 /'.)J
LOOP FURN. . . . -W GLO DRYERS. . I 8PLC $ 15. 00 JH 06/01/9.3
Mir :0 U114LR UNI [L).- 1 1;11-j I)C t. L80. 00 J11 061 47, 3
GAS OUTLE3 S: I PARK $ 500. 00 JH 06/01/9,--
11P R I t +:'. `-d IM 06 01/9
�
D E ANDERSON INC MPLC $ 110. 68 JH 06 'Zi I/C)3
11--43 L-W -)(-,T+l AVE: M51:11L $ 2.1. 111 J'11 06/01/c --
J."
PPRP $ I_3 E,. 15 V t JH 06/01/93
--,,VER`T'lJ �i OR Ij b. u.3 J!1 06/0 1
P11c)ne 43
�,t ract 0
1.
I;NUERSON, INC
4 .75 SW I'UCKER AVL
14. iVL-.FiTUN OR 9',-007f-
Pt!:.jrte #: 6a7-9999
Pt0. 46344
2860. "'1 r OTAL
This pertit,ji issued :abject to the regulations contained in the AENUIRE ' TNSPECTIONS
'ija;d guritipas' Udit State of Ure. Specialty Codes arc all other oat/found Ins Fireplace Insp
,iWllicabli All work will he sane ir accol, h approved Post/Realm ij Gas Line Iri-,p
plart This paroit will expire if mor� -,(Is t/Eieam -0kt. 1, elation Iris,
avof imsuance, or if *ork is su 1-1 ridslab Inso Gyp Poaid insp
dcl-flaor Rain drain Ins.
Sig - ILal !hSp Water Livie
Appr/SdwLk TI 5
k-r am) P 1e C 173 n L C 01 i
JCl�ll»P1 L'U i`�I�I L':L i ♦l,►jti
CITY O F T I GARD
PPL RMIT El 13 M I T #. . . . . . . : 5WR93-01 -
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall MO.Tigard,Orc9on 97223*8199 (50)639-4171 DATTI- ISSUED- 06/01/1).3
('L 0DIML16'-i. . . . 12199 GW ANYON Im
PARCEL: 1SI34CE- 147t,
11)1V1,:IUN— . : (41%AIUN PARK 13. LONINUt R-7 PE,
. . . . . . . . . . t . . . . . . . . . . . . . :674
F1XTURF UNITS. . .
5A NC. . . . . . . . . .
1-4:7 WORK. . . aNEW WELL I NG UN I Ni. I
-1-1E OF USE. . . . . ..5F NO. OF SUILDZN6!3: 1
451VALL I YPL I'1181WR IMPE.RV 5URF44GE. . r f
FEES
U C PM)ERWN INI: type M 0 1A0 t by date I-9L liL
4Z,2'5 6W 9G`T'H AVE. PRMT 2100. 00 JH 1216/1211/93
I WBr, r 35. 11)0 JF-1
LAr.AVL--,R70N OR 9700t.
:me Oli b27--9'-3tj9
'10R N(J'T LIN E=ILL'
Pf,une 0 . 'TOTi4L
REQUIRED INSPECT.'ONS
This Applicant agrees to cosply 104 all 00 rules and regulations sealer- lnspec,tiur)
of the Unified Sewage Ntricy. The ptrait expires 180 days f,as
t`,e date issued. 54 total avount paid will be forfeited if the
At expires. The Agenty does not guarantee the accuracy J the
side sewpi, latprals. if the smser is not located at the spasuresont
-i-ion, the installer shall prvsrect 3 feet in All 6-ections frog
tle dis,dxe given. If not so located, t� i purr!
i Tap iad 5idp Sewer' Pvrsit ane
I >sut rl BV •
..all f ut, iispeaticir, 6.39-.4175
c� p
i�iassw��,anae PA
PLNCK/RECT R
ClIT OFTIGARD Pf RM I T S
COMMUNITY D[-VELOPMEVT DEPARTMENT Tabard Onc6oin9727J
(503)63"171 DATE ISSUED
JOB ADDRESS: _9 �� -�-1 y��P'A) �.�'� TAX MAP/LOT
SUB: !��`JTr7J1 L.OT: LAND USE: _
VALUAT I OL!:
OWNER SPECIAL NOTES
NAME: �� .. SDS r REISSUE OF:
ADDRLS:i: _4, �'' _ LAST REISSUE:
—�-- - t 7 �L FLOOD PLAIN/
PHONE: —�� - � --_---- SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIREQ
NAME: _— -- "t� --._ PLANNING:
ADDRESS: _— _ _. ENGINEERING: --
__ FIRE DEPT:
`G- _
PHONE: — —_ ---- _ OTHER:
CONTR. BOARD #: EXP DATE: —
ITEMS lZEQUIRFD
SUBCONTRACTORS: PLUMB: �JCC�C LIST/SUBCONTRACTORS: _ —_—
MECI{: �i0 t BUS IAX:
/1f�CH ENGINEER CALCULATIONS:
NAME: -_, � ���-�'� — TRUSS DETAILS:
ADDRESS: --- -- - -- —_ OTHER: �— -- ---_-- --
PHONE:
:
PROPOSED BLDG. USE: —1 _—.---- — ------ --`—
COMMENTS:
APPLICANT „'GNATURE
Received By: ------ Date Received:
PERMIT # ACCT # DFSCRiPTIOR AMOUNT AMOUNT PD. BAL. DUE
MfLf3-_P21/ 10-432 00 Building Permit Fees .�S• _ _ �,`L
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Perait Fees
10-230 01 State Building Tax (5%)
Building 17, 60
Plumbing Go__
Mechanica? 0 -1,v
/
10-433 00 Plans Check Fee /
Building _ �/U /r. /
P1 umb,,ng _
Mechanical
10-230 06 Fire
-",tea U 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 U50
25-448-05 Mass Transit TIF fees //0 / //0
52-449 00 Parks System Deg Charge (POC) �U� / � 500
31-450 00 Storm Drainage Syst Dev Chrg
(;SOC) �1 — ---
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL y' � D ' �7 ✓�,2 y l
ng/35371,.wrf
�
'
CITY OF TIGARD — RECEIPT OF PAYMENT RECEIPT NU. :93-240715
CHECK AMOUNT x 4955. 29
NAME x MEADOWBROOK DEVELOPMENT CASH AMOUNT x 0. 00 |
' |
ADDRESS : PAYMENT DATE : 06/01/93
SUBDIVISION n �
|
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAlD �
| --- ---------'--' ---'-- ---------- --
/ 352.00 PLUMBING PEP . 132. 50
.
43 �� 8T BUILD P� � 28
MECHANICAL P� . . 4/.
PLAN CHECK FE 25. 88 SEWER USA 2100. 00
| SEWER INSPECT 35. 00 PARKS SDC 500. 00
|
'
STORM DRArN SDC 280. 00 RESIDENTIAL TRAFFIC FEES 1351a. 00
| MA88 TPANGIT TIF FEES 1io. 00
|
�
' LOT 74 ANTOm PARK
12199 GW ANlON DR
|