16696 SW JORDAN WAY •rte ,�,u {,�y� � y +�r�s`7rr��y,{��',`y w�Mw� 11�1 w� ,y}�q'y�
t� .i�5�rn ��.•� Y: �r�"� ++ :¢�+� �^ F.°1��J��N'. � �y W�i&,tiT�`r'f ��'',`�,t '.���N'� � •�'"'.��� 'R,e". r
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CITY
TIGARD C'';RTIFICATE OF
COMMUNIT`' DEVELOPMENT DEPARTMENT OCCUPANCY
1312681h HaIIBP :."Igerd,Oregon 97223*Bigg (50304!71 PE:RMIi' 1F. . . . . . . Q M;T'j3,
62"9 ,.I DATE: ISSUED# 01/20/94
�raRr_�:L r: X31 ic-,AD-�>�Irt��m
1 '31TC fa17DF'ES:�. . . s 16696 SW JORDAN WY i
3L'BD M S I ON. . . . I BEDFORD (3L.('-"N717N I NG I
iKOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . 120
CLASS OF WORN, I NEW I
T"PE; OF USE:. . . s SF
OCCUPANCY GRP. Q R3
OCCUPANCY LOAD s 1 19 4
i "1r1N', HAMS. . . .
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h etaaarks I PATH 1 �
Owners _...,.,_.,.__.,.._...._........_._.__._..__-.__»_.. _ ...... _..,___
11► PCON HOME:O INC.
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Contr.srt or Q
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i?�;WC:ON WMES t
3 -)'i12 0 aW 12!3.1+4
a
t BEAVER'TON OR 97005 f
Phone 11s 5124--199'
Peg 4. . % 7078
C1ocupaocy of the above ref'er&ncr.d bu . ldinp is hereby give7; and certifies �
the compliance with the State Of Or gon f3poc.ia) ty Codes fur the grow. . ; I
oc:cupanr_Y, and I..tse Under which thr! re-'erencied permit was iss1.1ed
RE-UGPARI'MFhtT 11.1 NO . IE.:CTUR
'JU I ll I NCS CJ
FROST IN CONSPICUOUS PLPCE
�r 'MYMiR.MWnrz.rMvN,lwq.YJ.M:'NYMY"° ,",U°„IA'•^'fIA1.t11.V • C y
NOW
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INSPECTION NOTICE
City of Tigard Ruildi.ng DePartment L-,x
131.25 811 Hall Blvi. Tigard, oregon 97223
Inspection Line (Rec-O-Pl,ons), 639-4175 Business Phones 634-4171
•90
Inspections_,—_
Footing P1!.y. Underslab Hoch. Rough-in Appr/Sdwlk
round. Plbg. Top Out Gas Line FINALS 1
Past/Beam Struct. San. Sewer Framing -Bldg. , i
1
Post;Beam Hoch. Rein Drain Insulation -Plumb. JI
Plbg. Undert.•,or Nater Line Gyp. Bd.
Date Requ,vated s 2t, ± Time s i.![ ,1 PM
Addrese s„1t !IG b ( )OV I -Ar'. (a � Permit f s��/! )Z3-dCZ (0c-?� �
_ THE roijA 17Nfl CGRRECTIONS ARE REQUIREDs
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tns tor: _
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�➢1'Hl)ViSD —� DiBAPPROVRD APPROVEn SUBJECT TO ABOVE
Call For Reinep.
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FAR",
INSPECTION NOTICE
City of Tigard Building Department
13125 S11 Ball Bled. Tisard, orwgon 9722 19f-
Inspection Line (P.ac-O•-Phone)¢ 639-4175 Business Ph 639-4171
Inspection: 1+1+
looting Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line
Post/Beam Struct. San. Sewer Framingldp.11
Post/Beam Mach. Rain Drain Insulation lyrb�)
Plbg. Underlloo: Nater Line Gyp. Rd. -Mach.
Date Requestedi_
j Tama: AM PM
Address:_ �1���`1 d � /1 In ( � Permit
Builders) -�i.T� �� + (.� _ �c" r C �'I ■
TRIP lh?LI.OwIN4 OURAECTI i1RB RBQMRP= v
e. b�;���� ��".fir•, 1 ilk`` 1,
Inspector: ~- -
---
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
-____.Cal.i For Reiuep.
1�NSPEMON KY ICE 1'
City of Tigard Building Departermt
13125 BW Ball Blvd. Tigard, Oregon 97223
I�
Inspection Line (Rec-O-Phone: 639-4175 Buninese Phone: 639-4171
�! Inspection:.
Footing Plbg. Underelab Mech. Rough-in Alpr/Sdwlk
Found. Plbg. Top Out Gas L`-ne FINAL: '
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line �nyF_ Bd1// -Mech.
Date Requested:_ to v� f� �� TiINt AM PM
I
Address: l IPA .30Y'44Lv- Lklelf, Permit 01��
Builders� CCC�QI/�
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors--- -Ff-/-�—� ``.•__� _ Date.
APPROVED DISAPPROVED '/ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE /
City of Tigard Building D + ......
I
13125 BW Rall Blvd. TLyard, Oregon 9; 2
Inspection Line (Rec-O-Phone): 639-41';5 Busineentione: 639-4171
Inspections
Ft sting Plhg. UnderslaL mech. Rough-in Appr/Sdwlk
k gI 9
=ounce. Plbg. Top Out one tine FINALS p
it } y >r.✓fit
IMF
Post/Beam Strut. San. Sewer Framing -Bldg. " o`
Post/Beam Hoch. Rain Drain C11lati n -Plumb. y
5A
Plbg. Underfloor Nater Line Gyp. ad. -Hoch.
Date Requested: I' I Time: AM _PM +
1 r -
Address& �s(P "IlP JL Permit f: � �-�,`
BuiWar s
TB'l' FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors _---- Date lWJ1—Z4 ' EE°
APPROVED DISAPPROVED APPROVED SUBJECT 'CO ABOVE
_Call For Reinsp.
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Lig 1 jpqTTQlt Building
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Cit? of Tigard Building epartaent SAI/// •
13125 SW R111 Blvd. Tigard, O—Von 97223
Inspection Iine (Rec O-Phone): 639-41"S Business Phon :/639-4171
J
Inspection:_
Forcing Plbg. Underslab Meeh. Rough-in Appr/Sdwlk
Found. Plhg. Tor, Out Gas Line FINAL:
Post/Roam Struct. `San. Sewer Framing -Bldg.
Pose,/Beam Mech. Rain Drain Insulation -Plumb.
Plaq. "nderfloor Nater Line Gyp. ad. -Mach.
Date Requested: Time: AMPM
Address: Permit 1: ` `?
BuilderslQ
' i�its dj�� l'; t •
TNS I/OLLONING OORRECTIOMS ARE UIRED:
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tin l 4r ,
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Inspector:_----� Date:
APPROVED DISAPPROVED APPROVED SUBJECT T3 ABOVE
_--Call For Reinap. 3
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INSPECTION NOT7_��
City of Tigard Buildla,I Itepartmeot-
131Z5 BW 'tall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phan): 639-4175 Business Phook: 9
inspsctiont
Footing Plbg. Underslabh. Rough-Ln� Appr/Sdwlk r
Found. Mg. Top outGaa
r Lint., FINAL:
f.
Post/Beam 8truct. Ban. Demr : aming -Bldg.
Post/Beam Mech, Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Ed -Mach.
Date Requ1e/sted: t�- ( 2- me
`Ti - r_7�M Cyd( pM
Addreast((� n nI L.- J-CN
A, JL 1-) 0,� Permit
puildert`L�CGt C Q�1 1( ►•�Q S + �, , �� I G� 9
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THE FOLLOWING COMEC IONS ARE REQUIRED:
/0 �N
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a i iy Inspector•
n�h't,f
Date: t.r
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fiAPPRDVIb DISAPPROVED AFPROVED eGBJECq' TO 11BOVi
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Call For Reinsp.
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DING CITY
15300 S.W.1 iC�h Avenue,King City,Oregon 9724 Phone;639-4082
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COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DATE •1 i r '_
1. NAME OF APPLICANT:Ll-
Phorle No.Ej-,-24`-/9 99 M
ADDRESS:_ _�,p�� . LC� 5 � y w� ;._ .t� ►> r,
ADDRESS OF PROPOSED IMPROVEMENT / C^ �•. S',. ,� ��y;�� _
i
2. TYPE OF CHANGE, IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT IS REQJESTED. �
DESCRIBE BRIEFLY - ATZACH TWO COPIES OF PLANS OR DRAWINGS OF
PROPOSED PROJECT:_ �-0 L=1e
3. NAME AND ADDRESS OF CONTRAC,TOJ�--, --.!� 7YL' ' _
PHONE NO. ' .�-/ -I /`7 1L 1 CENSE NO. 7 4
4. NEIGHBORS WHO MAY BE AFFECTED BY TiiIS PROJECT WILL BE NOTIFIED BY THE CITY.
5. APPLICANT OR HER/HI:7 REPRESENTATIVE MUST BE PRF.SMT AT THE PLANNING C044ISSION
MEETING NEXT 'iELJ) OIi
REPRESENTAT?✓ES NAME_ ___ _ PHONE. NO.
(The King Ci!y Planning Commi:.inr 'der only those appli^a`.ions received at least five (5) days
prior to a m g,)
SIGPiATURE
APPLICATION RECEIVED BY < j --DATE—
APPLICABLE
DATEAPPLICABLE FEE RECEIVED $ ,cj TOTAG�� —
PLANNYING C0MMISSION DECISION: Approved, _ Denied
CONDITIONS a ����'. t.T� 4'�
— Approved a 'cations are valid for sii months only
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Signature 2 �� I ,Date C �
MOTE: egon Borebuilders Law regui. es that a',l persons who contract for work on their residence be
egistered with the hilders Board which meaus the contractor is bonded and insured on i' job site,
For your Protection, be certain your contractor is registered by calling City Ball Ph: -1,082.
NOTE: A permit must also be obtained from the City of Tigard Department of
Camntnity Development Yes__ No
CITY OF TIGARD INSPECTION REPORT
The above listed project: has been inspected and Approved Denied—.—
Date Comments
Signature _
(&Litd,ing inzpepAon- I►tvaA¢. A_QAuAn one, 1 1) e.opy to king ''i!)
C0 2-81
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10101
6 � ►1
rNSPSCTION NOTICE
City of Tigard Building Depar L-aent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phones 639-4175 Business Pho t 9-4171
- ; f� (/
Inspection:__ l,(� ..�,
Footing Plbg. Underslab Neeh. Rough-in Appr/Sdwlk
bund. Plbg. Top Out Gas Line FINAL:
Past/Beam Struct. Ban, sewer Framing -Blc j
9•
Post/Beam Mach. Rain Drain Insulation -Plumb. '+
kY �
Plbg. Underfloor Nater Lir.• Gyp. Rd. -Mach.
Date Requested s 7-/-9 3
Time: _L_AM PN
Address �r' �
Permit ii_- v
Bu!.ldar s L 4(xyll l IAM
TNS FOLLOWING CORVIVTIONS ARE RSQUIREDs
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Inspectors_ ......
APPROVSD —_ DLBAPPROVSD
APPROVSD SUBJECT TO ABOVR
Call For Relnsp.
", ".......•.yl,yr,..irwM1r•'LW Mi.n'TM+Ylll'+FM.r..rhfAi.•. .r.......... ^*•wW
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INEPECTION NOTICE
City of Tigard Building Depa 'tet S
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspoctioa Line (Roc-O-Phor, )z 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found.,.-__. Plbg. Top Out Can Line FINAL:
/POat/seam stxuct� Ban. Sewer 1s.•aming -Bldg.
lost/Beam Mech.' Rain Drain Insulation -Ply,
Plbg. Underfloor Mater Line Gyp. Rd. _Mach,
0 -_ G�^
�
Date Requeateds ---Time: IM 11K
Addra To:_11k �c 1 tk.0 t1 `OCC Permit
Builders
THE FOLLOWING CORF.ECTIONS ARE REQDIRLD:
i
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Inspector: � I
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P'.OVED DIS PPR D APPROVED SUBJECT TO
_ 11 For Reinep.
F
NSpECTIONNOTICE i
City of Tigard SuL.ldiug napart..ent 1 %
13LS "!: loll Blvd. TLgard, Oregon 97223
InspectionLine (Rec-O-Phonr)c 639-4:75 usiness Phone* 619-4171
Inspections__ ,` (fin
Booting Plbg. Underslab Hoch. Rough-in Appr/Sdwl.k
Found. Plbg. '`op Cut Cas Line FINAL-
root/Beam Struct. San. Sewer Framing -Bldg.
it/&%-y= Hoch. Rain Drain Insulatioc -PlumL.
i
Plbg. Underfloor Nater Line Gyp. ed. -leech,
Date Requested: Timet �1M p!l "
Address f �c u .1LJI=.��V� �L�Ct Pes'eit E f "' 3'&-,,,,
Builder /c ���tC - ( I�Z C e ■
THE FOLLOWING CORR'&MONS ARE REQUIRED:
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Inspector: _-
----.-- — � Dates
-- — art
APPROVED
DI3APPROVEO APPROVED SUBJECT TO Agp:rE
Gall For Reinep.
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INSPECTION NOTICE /
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City of T}oard Building Departaent (�
:3125 SW Pall Blvd. Tigard, Oregon 97223 h
Inspection Lino (Rec-u-Phone): 639-4175 Buoiness Phones 639-4171
Inspection:
rooting Plbg. Underslab Nel:h. Rough-in Appr/Sdwrlk
round. Mg. Top Out -as Line FINAL:
Post/Beam Struct. �.-NwBi� Framing -Bldg.
Post/Beam Hoch. Rain�(ln Insulation -Plumb.
--v
Plbg. Underfloor Nae Gyp. Bd. _M h, ;
Date Requested! TLae2a
AM PN
fes'
Address
Builder: , "V'.'E ,i
THE FOI.I.OWING CORRSC?ION9 ARE hEQtlIAED:
-- — y4`r7!}T7 M�
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Date!__
APPR9VSD -- DISAPPROVED A')PROVED SUB.TSCT TO ABOVE
Call For keinsp.
INSPECTION 4-0-TIc
City of Tigard Building Department
13115 SR Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection:
f
' meting Plbq. Underslab Hoch. Rough-tn Appr/Sdwlk f
!Found. 1 Plt.g. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg. S
Post/Beam He:h. Rain, Drain Insulation -Plumb. �I
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Tete Requestede J Jf� I rl Time: ` )^ P4
Address:_1(DLF' ''�(p .�SY`'.Ge c� �l. Permit to 413 10
THR FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:._
— Dates
APPROV3D DT3APPkOVED — APPROVED SU&TELT TO ABOVE
Call Pr . Reinsp.
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CITf OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
I� ,13126 8W Hall Blvd.Tlpud,Oregon 07223.6100 (603)83P-4;71
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-•lRDPIGE 1)3. ill. . n . I2�i1 {"•) l!t+' 4 f"�' 1 r'r_'!
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'zrd AVICIP0 *rdf, btite 0f U"B. ippciiditY LOi,@L a,' JfJt•:' h',:, tl'Id 11,1
Jllcat•l! laws. All *ark k(l) br• atne ;t; amirls—P :itrurvt l.-ias LJr,R rit.p
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'(his pvriit W1li eXplre ,` YWw-ii i5 not o '{;;,, i}_i@3ri IF+l`..`'Is11?
1'b 0� issm.Cpl u. :` w01"'F R' + +.lf�t:k:i ( el 0 1?-15itivl k3o,ilr':7
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13125swit.unwd. PLNCK•/RECT N
CITY OF TIGARD
PO Box 2339; P'_RMIT q M503 -OA
��
' Tigxr�Oregon 97113
COMMUNITI' DEVELOPMENT DEPARTMENT
(503)639-4171 DATE ISSUED
! JOB ADDRESS: 16696 SW Jordan Way TAX MAP/LOT4 jD —_
SUES: Bedford Glen LOT: 20 —__ LAND USE:
VALUATION: 7/ 4/3r
OWNER SPECIAL NOTES
NAME: Beacon RouesInc. REISSUE OF:
ADDRESS: 9500 SW 125th Ave. LAST REISSUE:
Beaverton, OR 97005 FLOOD PLAIN/
PHONE: 524-1999 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: Beacon Hanes, Inc. _ PLANNING:
ADDRESS: 9500 SW 125th Ave. _ ENGINEERING:
Beaverton, OR 97005 FRE DEPT: _
PHONE: 524-1999 _ _ OTHER:
CONTR. BOARD #: 70782 EXP DATE: 12/92
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ Canby Plumbing LIST/SUBCONTRACTORS:
MECH: tUehe Quality HeatingBUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: Argo Arrhit.ectAIA TRUSS DETAILS: _.....
ADDRESS: 16325 SW Boones Ferry Rd. 201 OTHER: _
.77 Lake Oswego,_ CS. 97035
PHONE: 636-0755
PROPOSED BLDG. USE: Residential.
^ e A __
COMMENTS: F•rG ISSN ��c tT. 0
APPLICANT SIGNATURE
Received By: _ _ _ Date. Received:
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PERMIT # ACCT , DESCRIPTION AMOUNT AMOUNT PD. BAL. DUS
h1st43 oR r 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees ?
_ 10-431 01 Mechanical Permit Fees
k
10-230 01 State Building Tax (5%) ?s" 3 G
Building Z, 7• V� '
Plumbing
Mechanical 3
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10-433 00 Plans Check Fee 50-, ►3 1/0 /U• 3
Building 46) `
Plumbing
Mechanical
r 10-230 06 Fire
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30-202 00 SeWC.' Connection
3�
30-444 00 Sewer Inspection
33
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
i
25-448-03 Office TIF Fees
i
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 cf)
TOTAL lv.3ZOf__ r '
� 7,
nm/3587P.WPF
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CITY OF T I CARD — RECCE. I F'T (IF F,AYME=:NI' RE:CF i PT NO. :9 ti-- 43,L-:'_`.`ir'
CHF.Ci'. AMOUNT 57 7. 490
INAMEn a BEACON HOMI`S CASH AMOUNT Vt. 00
(ADD RES S PAYMENT DATE 0)8 139,--;
f-,URPOGE OF t�AYME N'f AMOUNT PAID PURPOSE OF F,AYMLf IT AMOUNT PAID
BUTI_DING3 PERM 3413. 017.1 f='I,-UMSING PF;tM 117. 50
MECHANICAL PE 40. 50 9"r. BUILD PER 25. 36
PLAN CHECK FE 10. 13 SEWER INSPECT 39. 00
3
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20 BEDFORD GE_h.N
16696 SW ,JORDAN WAY
I TOTAL AMOUNT PAID r 577. 49
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LLGLLG ❑
f sewe ape SAN iTARYA D o
agency SURFACE WATER
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f155 H. First Ave.,Suite 270,Hillsboro,Or.,97124
503 848-8821
C L)N 141 (:'1 ) 014 1"1 11'i J '1' ;
IA VI: l)1') 1 i','.". ,';(F,i' 1'C'rI)m rinrr. a 'l'�; a C?11T.'I' 1ti;n i .
1 I';IIr T IIr*%,I (trIrIriF' 1 e)e)i e, F'F?0,11
I:: I' ill .111)tDAN WAY '
1..Ci'I (; III (11"K
1: 1.'0N M 1'.1" I' 11.)i•I NNW 01" 1)r 1:11`0101) lil..FM P11 Vi r.: 2
I 'rC'F' J Id'; I'F l I F 'r:rC)f,l r J.'? ) ):II.)! r;1.)n r,i2o (:III,i,
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III;C;Il1',1Mr,•i ( 1. ) > rt�it')L.r:: V,A1-1 1..Y lA1?i;I:I. '!'i1. 1.•, r1 LI ;"°;^,00
011 F h I'i l e" I l l i ; CI
)Will;. I:II"tll;[)h! I!I)f•fl l:;
9,510(1 ';lJ I :?1,'111 rF;l""A1,MVI,! I* i'1 ,lfl1 )IIIIII(,i
BEI)Ul:'i? 1'00 OR 7700
II0 NE ":;?4...1999 !IJr: :C':I11 KIN(-; 1: :1 '1 Y
I'I! f IciPE FQI.IJ�ALF;1NXT'.i O.O W 1
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("1 0 M M E,C T I Cl M F'FLS 1011.11.1 ACX 16YIF:k rII 111'1 (II'14114T I I ta'
f3E:!dr:l? I';t)M�lf;1;}'I:LI>`i ;':?Or) , q0 !!r1'i'!i:It IIL!Ill.1 'rY 1L30 ti 00
J CIO,00:'.•
IdA I*I:: 1:111AN I' I: 1'Y 1.00 00
ERIV; 01)11 I1,0 N r1 uI-
T:1014 40, 00
PLAN I II1.:1 K 26.,00
',3U1) I'f) I';11. ;!':',OO , O0 'J1)I11'1) fill_ J ,:,;, : 00
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j I id!1111 !''! ! t:l: IC11'i';li
l'! '' I'( I,l 1{11.`.•'..,;' (�E (lf 1)I,:rI not 1",14
00'1Pr D
lrrlrall.11� � �'!
Parmlt Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. When calling
for an inspection, please refer to the Permit Number. The Permit expires one hundred eighty (180) days from the date of
Issuance. The total amount paid (permit fee. connection charge, line tap fee and/or other charge) will be forfeited if the
permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. if the sewer Is not located at the
measurement given, the installer shall prospect three feet in till directions from the distance given. If not so located, tho
installer sh!ll purchase a "Tap and Side Sewer" Permit at the current charge and the Agency .1111 install a ldteral.
6/90 WHITE — USA, BLUE — Accounting, GREEN —Inspection, YELLOW — Customs[
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