11040 SW GREENBURG ROAD I
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CRYOFTIVARDNUil.LINC, PERMITCdlfif OF TWA
COMMUNITY DEVELOPMENT DEPARTMENT onooN I'I RMII" #. . . . . . . .. BUP92•-•0066 l
13126 SW HWI WNd. P.O.Boot 23397,Tip W,(Argon 97223 (603)839.4176
ITE ADDRESS. . . : 11040 SW GREENBUR'G RD PARCEL% J 91;35CP-02800 i
;UBDIVISION. . . . : "ZONING: R- I,:'
BLOCK. . . . . „ . . . . . I_Cll.. . . . . . . . . . . . . .
1"LEI SSUE: FLOOR AREAS--_____..__._ .._ E'XTERIOP WALL CONSTRUCTION--
I�LHSS OF WORK. :REF' FI RST. . . . c s f N- S. E.: W:
TYPE OF USE. . . :MF SECOND. . . c sf PROTECT OPEN INGS?___._-._.. ._.._
TYPE OF CONST. :5N THIRD. . . . : sf N: S: E: W:
OCCUPANCY GRP. :R1 TO'rAL-------• 0. s f ROOF CONST:B FIRE REI"? :'Y r
OCC::UPANCY LOAD: BASEMENT. : r,f AREA SEP. RATED:
STOR. : HT. : ft GARAGE. . . : sf OCCU SEP. RATED:
B SMT?:N MEZ Z?:N REGID SETBACKS-----------
FLOOR
E:T•BACKS--.--•-.-----FLOOR L_OAD. . . . : 100 ps f LEF"T: f t RGHT: ft FIR SPKL.:N SMOK DET. . :
DWELLING UNITS: FRNT: ft REAR: ft PIR ALRM: Y HNDICG ACC:N
HF1)RI+IS: BATHS: IMP SURFACE: PRO COl'R:N PARKING:
04LUE:. $: 4500
9emarks : REPLACE. ROTTING STRUCTURAL_ MEMBERS, REPLACE SIDING ON DECKS.
L14JT1eY,. — ___ ....__..._......_.._ ._..._ _ _ _ ._ _ _. ._.__ _ _ .._ .__..___ _ ._.___ FEES
05H CREEK PARK CONDOMINIA type amoUTIt by elate recpt
PRM1' 1; 50. 50 JI-1-1 03/25/92 -
PLCK $ 32. 83 JL.H 03/25/92 —
5PCT $ . 53 JI-H 03/25/92 -
!-i�ppe #:
—AYI S CONSTRuL.T ION
7400 SW M I LWAI Ir'T E AVE
PORTLAND OR 9720c'
Ph ur1 e #c 233--4789 $ 85. 86 TOTAL
Reg #. . : 040.17
RE UU I RED INSPECTIONS ------•---
Phis permit is issued subject to the regulations contained in the 4=•raminq Insp
Tigard Municipal Code, State of Ore. Specialty Codes nd all other F raminq Ins 1j
applicable laws. PP work will be done in accordance ,pith M.I.SC:. Inspect i url
approved plans, Th's permit will expire if work is not started Final Insper_.tiori
within 198 days of issuance, or if work is suspended fo, more
than 198 days.
Q4e r m i t t e e ca i y r1 a t
1 s s u e d B y :
C:aII far nSpeC:t J.0r; - 639--4175
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CYT'Y (II"" 'TJ'Ci IRD RE'C:F"lf'7 OF F'il`rlhE-14'I' Pr I. xF'1' Ai(a. s'J;.' c'r.'.
NfiMC �.,,, CUNl3T RUC Y'r ON CASH AMS LIN'r 0.00
Flllixti :E::f:t!; PAYMENT' DATE
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1'tJF F'i2i3F OU, PAYME141 MOUNT F-1011) PUI'<f-'OS1:: GF 1'IIYi'If::NT' AMOUNT PAID
k!l.la I..t�J Ni' I r:r hl !J0.50 PLAN CHECK rE :32. 83
S1 . F U'CI._T) PERi.'.. °a:3
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SA GREENDURD
i t:iUo AMOUNT PAID
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CIT"Jil OF T 1 GARD PO Nix 23397 PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT Tp rd,Orc,eon 4722.7
(503)6344171 DATE ISSUED
JOB ADDRESS: �� � � ✓ cam` TAX MAP/LOT
SUB: LOT: LAND USE:
VALUATION:
OWNER NPECIALNOTE�
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NAME: ��.� Zl�_��,�C,�`Zrnin�C�. _ �_ REISSUE OF:
ADDRESS: _ LAST REISSUE: _
FLOOD PLAIN/
PHONE: _ __— SENSITIVE LAND. —_
i
CONTRACTOR APPROVALS RE_QUIREO
NAME: ZQ z f- Con (w ,7 C &22,-7T__— PLANNING: lv,
ADDRESS: _—____ _ ENGINEERING:
FIRE DEPT: _ —
PHONE: _ OTHER: —
CONTR. BOARD #: �x�'��-- EXP DATE: —_
ITEMS� REQUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS: _—
MUCH: — — ^— _ BUS TAX: _—
ARCHANGINEEP, CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: —_ —_ OTHER:
PHONE: -- --- —� —_ -------- i
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PROPOSE^ `?',DG. USE:
COMMENTS: ----
APPLICANT SIGNATURE
Received By: �— Date Received:
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PERMIT # ACCT # DESCRIPTIC1 AMOUNT AMOUNT PD. F1L. DUE
10--432 00 Building Permit Fees SQ.SD
h •
10-431 00 Plumbing Permit Fees
i. 10-431 01 Mecha `.cal Permit Fees
10-230 01 State Building 'ax (5%) .x.53
Building
Plumbing
Mechanical
•
10-433 00 Plans Check Fee 7�•�'
Building �___ _ �•
Plumbing ---
Mechanical
i
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
f 25-448-06 Institutional TIF Feet
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dc� Charge (PDC)
31-450 00 Stores Drainage Syst Dei Chry
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445--02 Water Quantity (Fee in lieu of)
TOTALS,
nm/3587P.WPF
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city of Tigard Building DOPartallent
13125 SM Hall Blvd. Tigard.
Oregon 97223(Rec-O-Phona)! 639-4175 Business Phone
Inspection Line639-4-17-1-
Inspections e/ ""K
Footing Plbq. U•.derslab
Mech. Rough-in Appr/Sdw1Y.
Found. Plbg• 'fop Out
Cas Line FINAL:
-Bldg
Post/Fioam Struct. Bari.
Sear Framing
Yost/Beam Mech. Reln Drain
Insulation -Plumb.
Gyp. Bd. -Mech.
Ylbq. Underfloor Water Line
Times // AM PM
pate Requeatedt
Permit 1 1
A i
Address:
Builders
THS ypLI,OMIIIO CORRECTIONS ARE REQUIRED,
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Date'_,C
Inspectors_
t APPROVED SJBJECr TO AROVE
APPROVED DISAPPROVED _
.� --Call
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Call For Reiner. V
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DEPARTMENT OF LAND USE&TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION
WASHINGTON
t 155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY,
INSPEc"PION REQUESTS: 503/640-3561/693-4415
OREGON XXXXXXXXX---> 640-3470
• Page 1 of 1
Date 03/09/95
Time 08 : 24
Permit Typ(� , Residential Electrical Permit Permit # 05064847
Permit Status APPROVED Applied 03/08/95
bitus Address 11040 SIN GREENBURG RD T.I. Issued 03/08/95
Permit. 'Title 5E'R - BURGLAR ALARM #104 Completed
Permit Descr. To Expire 09/04/9b
Project 'Title SE'R BURGLAR ALARM #104 Project # P0048142
Project Uescr. * EROSION
Parcel Number 21,ilTl - Land Use District
Valuation U
Legal Descr . w
Owner 1NSPEC1'1UN - T.LGARD Construction OTH
Applicant Name ADT Classification 900
Applicant Addr . : 703 NE HANCOCK Occupancy
PURI-LAND, OR 97212 Vaiidated by PH
Applicant Phone : 284-3265 X35 Inspector Area
E'ee description Units E'ee/Lluit Ext fee Data
Limited Eneray/Alter./Extension 1 40 . 00 40 , UU
Subtotal Electrical E'ees : 40 . 00
State Surcharge of b% 2 . 00
'i'otal Electrical E'ees : 42 . 00
*** E'ees Required *** *** Nees Collected & Credits ***
---------------------------- ---------------------------------------------
Method Check # Receipt No . Date Payment
'DEP ' 03/08/95 42 . 00
E'ees : 42 . 00
Adjustments : . 00 'Total Credits : . 00
Total E'ees : 42 . 00 'Total Payments : 42 . 00
Balance Due: . UU
NOTICE: This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction hits started,
the permit becomes null and void If construction Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleadlnll Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or stricture will be compiled with whether or not specified on the plans or noted on tits plans correction shoats. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspecti,)n staff verifying compliance with the various codes. Use or occupancy of the building or stricture permitted prior to approval by the
Building Department Is solely at the risk of the applicant and Ruch use or occupancy Is revocable until all Inspection requirements are satisfied and
Rpliroval Is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is Issued
opacifying that the use or occupancy of the hullding or structure Is provisional and revocable until the satisfactlon of all Inspection requirements.
APPLICANT'S SIGNATURE
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. '!�,IIVL�3JMLfMpn,:!l:Su..-IV-•.,'a• '^='"'rs- r a:.,y,....*n. .•yn.:,. .: t,«,rr..r._'. kMbLLWiti§b°i.'11�r.4ygtWYrywL .,,, 4M1v .:il_}L'+ •1Y.
WASHINGTON COUNTY RESTRICTED
Department of Land Use&Transportation
155NorthinsFirstAvenue, #350-12 ELECTRICAL ENERGY
Hillsboro, Oregon 97124
hiforinmflon: (503) 640-3470 Fax: (503)693.4412 APPLICATIONPLEASE PI?INT
lefi? all sections, 1 I
Permit No.tea e om); through 5.
'r/� LI I'
1. Location of installation Date - - �1,
Addressfl i1 c-_ �1SL'ft4 A
4. T e of work:
City - ����------- Zip Code `� ---- Yp
Map No. -----`___--- Tax Lot
RESIDENTIAL Restricted Energy Fee $40.00
(for all systems)
Thomas Map Book: P e Section `(
Check type of work involved:
Directions_ � J a"
Audio and Stereo Systems'
4rglaAlarm
Commercial F-1ResidentiallephResidential aleph ne S
i- one Systems"
Tenant NameGarage Door Opener*
(if commercial) _ __ ____._- Fire Alarm
Heating,Ventilation and Air Conditioning Systeme
2. Contractor application: Vacuum Systeme"
Other
Flectrical Cootractor -� _
Address ') �— - COMMERCIAL Fee for each system $40.00
City_ State Zip _17, 7/Z (are OAR 91 9-2M200)
Date Job Number Check type of wank Involved:
Property Owner __T�'7V) G 4 Vele—
Contractor's License No.
Contractor's Board g. No, � 9 9 y Boiler Controls
Clock Systems
Phone No. R Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: - HVAC
Instrumentation
Print Owner's Name Phone No. Intercom and Paging System
_ Landscape Irrigation Control*
Address Medical
_ Nurse Cells
City State Zip Outdoor Landscape Lighting*
This permit Is issued under OAR 818-320-370. The applicant agrees Protective Signaling
to make only restricted energy Insfallations(100 volt amps or less) Other _
under this permit and to do the following: —��-
1. Only use electrical licensed persons to do Installations where
required. (Certain residential and other transections are exempt Numbe: Of Sys!ems
from licensing. These have ssferlsks M. All others need licens —
ing.) r "No licenses are required Licenses are re ui,ed for all other insinllation.s.
2. Call for an inspection when ell_he installations under this permit Q �
are ready for Inspection.
3. Purchase separate permits for all installations that are trot ready 5. Fees
for Inspection when the Inspector Is out to Inspect under this
permit. Enter fees
4. Assume responsibility for assuming that all corrections required
by the Inspector are done,and �-
a a 05
5. Assume responsibility for calling for•liner Inspection when all of 5% SurchX total above- ) $ � l i
the corrections ore completed.�- -
The person signhy this per t st bs the applicant or a pr sen _
C Trust A $
authorized to bind the sp ca
C.. -� Total $
Signature _._. �_ .�..-
Authority if other than applicant _ ____ ___ ___ This permit becomes null.nod void If the work authorized by the
permit Is not commenced within 180 days from date of Issuance
For Inspections call of such permit or if the work authorized Is suspenders or abandoned
640-3561 o r 693-4 415 any time after work Is commenced for a period of days.
Electrical Permits are non-refundable and non-transferable.ble.
24-hour recorder, one working day In r nre of need BL24-114
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