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C11Y OF TIC-ARD
COMMUNITY DEVELOPMENT DEPAP TMENT CERTIFICATE OF
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503,639-4171 OCCUPANCY
> PERMIT #. . . . . . . a M`.'T93
fa 39 4i'7.1.
oATE ISSUEDa i2/29/93
3 ■
� !''ARCEI_t c L'S 1 1 faFiD -PF'D6 J I
aITE:. ADDRCSS.i. . . t 16773 'w;W ,,ORiJPN WY
';UBDIVISI`N. . . . i BEDFORD 63-EN ZONINGr
T:t1_OCK. . . . . . . . . . t L 3T.. . . . . . . . . . . . . 163
CL.ASS 01 WORK. r NEW
TYPE OF LIGE. . . r f F �
13CC;UPANCY TjRP. s R 3
OCCUPANCY LOAD e 1. 1 7 4
FENANI NAME. . . r ■
Romcar•kz : PATI-1 I
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BEACON HOME 13 �
0 BOX 13(pH
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BEAVE•.:RTON OR 97007
7
Phon'2 Ov 1303-5E.4-19`)9
BEACON HOMES
'3 X5700 SW 1 c?'.."TI-I
BEAVERTON UR 97005
s Phone #t 5- 24 -1999
flvg #. . : 707V2
Occupancy of the above refforenced huixciing is hereby yivart, and vert .ifiew
the compliance with the State Of Oregon Spel-salty Codes for the group,
()C-C:Llp,-4ncy, unci _Ir3e under which t;hp ^eferenced permit w6as isskied.
F IRE DE'PARTMEN.I L.1)I..N % SPIrC TOR
—' E3 ILDI OFF7ICIOL_
['11711ST IN PLACE
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ECT ICE
City or TigZrard. Building Department
13125 SW Hall Blvi. Tigard, Oregon 972231
inapeation Line (ROC-0-Phone); 63?--4175 Business Phones 639-4171
Inspections
Footing PLbg, Underelab Mach. Rough-in Appr/Sdwlk
I
Found. Plbg. Top Out One Lin* FINAL.,
Poet/Ream Strust. San. Sever
Frami:sg
T4s-%
Poet/Bean leech, Rain Drain Ineulaticn
P.lbg. Undern-jor Nater Line
Gyp. ed. -Neth.
Dale Requested:
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Address: J ('}/IQy� (.lam Permit �r1_`�3"��`(�
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ii Builder: �L� I c%� P`') ISA t.l �j�j� C./n/ l -7
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THR FOLLOWING
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Inspectors - --
'-'— Deter
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-,APPROVED DISAPPROVED APPROVED /3UBJL'CT TO ABOVE
_Call For Reinep. ;11�s%nr
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��� NUTICE � 1✓ �--_
City or Tigard 17uildimg Oepartatent
13125 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)r 637-4175 Business Phones 639-4171
Inspections__
Footing Plbg. Underelab Hoch. Rough-ir, Aber/Bdwlk
loused. Plbg. Top Out Gas Lissa �lINALe
Post/Beam Strutt. Ban. Bower Framing
Post/Beam Hoch. Rain Drain Insulation Plsssb�
Plbg. Undarrloor Walter Line Gyp. Rd.
Bate Requested: �i l'( ---Times __PK
Address si
6LV�Ll.�f�.�a_' P..Linit 4 s'l 61 G]5
Builder: l A f t")"� �DYV4"5 �-- I �ci i 1 4 �q 1 ']
TM IULLOWING CORRECTIONS AAE REQUTAEAs
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Inspectors �— 1�
-- Dates
—APPROVED 4 D29"YROV�ED APPROVED BUBJRCT TO ABOVE
CCC,111 For Reinsp.
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INSPICTION NOTICE
City of Tigard Building Derartaant
13123 SW Hall Blvd. Tigard, Ors9cm 97223
Inspection Line (Rec-O-Phone): 19-4175 Busineau Phone: 639-4171
Inspection:
Footing Plbq. Underslab Mach. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Bas Line FIMPLs
Post/Beam Struct. Ban. 84no Framing -Bldg.
Post/Beam Mach. Raln Drain Insulation -Plumb.
Plbg. Underfloor ��l '� G Bd. - ech.
��}}
Gyp.
Date R X'1 -2L
�Z ` '
Requested, i_ 7� TLaos,�AM PM
+ Address: 3 �L Permit i 1 1: ,
Builders
TBE FOLLOWING CORRRCTIONS ARE REQUIRED:
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Inepsctors_ Data:! ��
APPROVED DISAPPROVED APPROVED SUBJECT a0 ASOVP,
\/ Call For Reinep.
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INSPECTION NOTICE �I
City of Tigard Building Departmwt+t
1312', SO Ball Blvd. T .gord, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
. . .
Inspections
Footing Plbg. Underslab Mech. Rough in ad-1k •
:#'ound. Plbq. Top Out Gas Line FINALt
Piet/Beam Struct. San. ^ewer Framing -Bldg.
Pont/Beam Mach. Rain Drain Instlation -Plumb.
P]'•+. Ung-rfloor. Water Line Gyp. Bd. -Hoch.
D._te Requeste�d7t_,. 1 `_T1Aet AH PM
Addresa t_ I l D 1 3 �Nda�l _k.� Perini # 7 °�'� ` r> C,S
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Builder: 6e --Fc"
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors___ Dates J 1177
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-_`APPROVED DrSKPPROVND APPROVED SUBJECT TO AEOVE
Call For Reinsp.
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PAP
INSPECTI��IA
City or Tigard Building Departn nat
13125 BW Ball Blvd. Tigard, Oreyon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 635-4171
Inspections_ _
Footing Plbq. Underslah Hach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out des Line FINALs
Post/Beam Struct. San. Bawer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb,
Plbg. Underfloor Nater Line Gyp. Bd. -Hach.
')Ice Roquesteds _Times _AH PN
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Address s A. / _ Permit t s '
Builders �
TBE FOLL)WING CORRECTIONS AAE REQOZREDs
-T
Inspecto s i Dates
-APPROVED w- DISAPPROVED APPROVED UBJECT ^.D ABOVE
_ Call Fore Reinsp.
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118PP.CTION ICE
city of Tigard Building Departaet / � �
13125 SW Ball Blvd. Tigard, Oregon 9:2
Inspection Line (Roc-O-Phone)s 639-4175 Business P„c:.�s 639-4171 {{
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Inal..ct ions
1
Footing Plbg. Undersl,%b Hech. Rough-in A:pr/sdwlk I
Found. Plbg. Top Out Gas Line ";AALs
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Post/Beam Struct. Ban. sewer. Framing -81.49. g
Post/Beam Hoch. Rain Drain Insulation -plumb.
Plbg. Underfloor Mater Line Gyp• ed. ' -Hoch. a
Date Requesteds 1 Times — AM p"
Address: I �i' � ' .� 1 ' 1 ( ( 1 r 1 Permit is
Builders
TBA FOLLOWING OORRECTIONS AAE REQUIP_,D,
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Inspectors Dates�,q �� »
APPRUVED DISAPPROVED APPROVED s^:,JACT TO A / }
Call For Reinsp.
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City Of Tigard Bui:.ding Departa�Lv:t
131:<< BW Ball Blvd. Tigard, vregc n 87223
!, Inspection Lina (Rec-O-Ph(one)s 639-4175 Busineus Phone: 639-4171
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Inspections
Footing Plbg. Unduralab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out
Gas L. qe FINAL:
ly
post/Ream Struct. San. Sewer Framing -B]d
g.
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Post/Beam Mech. Rai:. Drain 'Insulatlon ` _pleb,
Plby. Underilonr Nater ino
Gyp. Bd. -Mech.
+ Date Requested: ^ Time: AM PM
MIresse' Permit
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BuL).derj
TB. FO" WINO CORRECTIONS ARE RA•QUIRED:
----------------
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Inepec*or: -- Z U
Date t
APPROVED QISAPPROVED Y APPROVED SUBJECT TO A3OVE
ALLy ,
?' ___Call, For R.einsp. F
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INSPECTION NOTICE
City Of Yigaud BuJldiaq Department
1312S 80 Hall Blvd. Tigar', Oregon 97223 iklL
Inspection Line (Rec-O-Phone): 639-41.75 Business Phone: 539-4171 S}
Inspection:_
Footing Plbg. Underslabt10oh. (tough-in Appr/sdwlk
Found. Plbg. Top Out �[ Cas Line FINAL:
Post/Beam Struct. San. Sewer l Framing -Bldg.
'
Post/seam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp, Bd. -Koch. lf� '
z",�aG� ■
Date Requested: ? AM PN
Address: S AOtAit ii /,-->
Builder:
TAR FOLLOWING CORRECTIONS ARE REQUIRED:
f n 1 fro fT �1Yi ri'lruF� n }:
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Inspector: � �- � --_ _ Dates '*" Z_4
APPBOVBD DISAPPROVED V APPROVED SUBJECT To ABCVB
Call For Reinsp.
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sPscTxoN Noxyce
C,'..tp of Tigard enildin j Dapart—
nt
_3125 810 call Blvd. Hgarri, Oregon 9722 ;
Inspection Lisss (Roc-O-Phone): 539-4175 Buei.neee Phones 639-4171
Inspect ion s --
Footing Plbg. Underalab Mach. Rough--in Appr/Sdwlk
1, Found. Plbg. Top "t,st� Gas Lino FINALS f •
t Aoet/Beam Struct. San, Sews,: r ,�rasinq -Bldg.
Post/Beam Hoch. Rain Drain Insulation --Plumb.
Plbg. Underfloor Nater Lino Gyp. Bd. -Mach.
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Date Requesteds / -,2 3S i /-- AM PM
Address:— / �'�rlYit
Builders
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THE FOLLOWING COMMICN/ BBB 1l10020s
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V.ifk, 19
V
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\ APPROVED DIBAPPROVHD APPROVRD AUBJECP To ABOVC
Csil 'For Reinep.
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pISPECTION NOTICE �.
Citi of Tigard Building Departme t
13125 SA Hall Blvd. Tigard, Oregon S 2
Inspecti, n Lino (Rec-O-Phone)s 639-4175 Busines. .hak, 3 4177
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Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Fount. Plbq ." Out Gas Line FINAL: z.
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Port/BE am S'.zvct. Ban. eew+s Framing -Bldg.
00, Pont/Be-am Much. Rain Drain Insulation -Plumb.
Pibg. Underfloor y/ater. Line Gyp. Bd. -Hoch. e
Date Requestods^ CG' .-:�� Time: _ Ax '1►+
Addr es a s �L,.�—='- - ��K.t Z1 rmit I c 4
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Builders ''
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THE FOL.OMIMG CORRECTIONS ARE REQUIRED:zof
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Inspector: Dates
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— APPROVED DISAPPROVED APPROVED 911BJRCT TO ABOVE
u,
Lli For Rainep.
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INS?ECTION NOTICE
city of Tigard Building Department
13125 ON Ball Blvd. Tigard, Oregon 9722',- " • "
Inspection Line (Rec-O-Phone): 639-4175 Businet:s Phone3�-49-4171 ,
Inspection:
Footing Plbg. Undarelab Mach. Rough-in s�pL/Sd«r.lk
Found. Plbg Top Out Can Line FINAL: 4
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poat/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line
Gyp. Bd. -Mach.
Date Requestede �� /�-- )� Timet _ AM _ PN
Address:_ / petpit 1.
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Builder:-
TRE FOLLOWING CORRECTIONS ARE REQUIRED: �
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Inspectors
APPROVED I ROVED APPROVED SURJECT TO ABOVE
es] Foy- Reinap.
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INSPECTION NOTIC$ p / t. (div. a
} City of Tigard Bu:teing Department C
13125 BR Stall Blvd. Ti,ard, Oregon 97221 P
Inspection Line (Ree-O-Phone): 639-4175 Business Phcne: 639-4171 G
Inapeetion:_---
Footing Plbg. Uneirelab Mach. Rough-in Appr/Sdwlk
A n
Found. P1bq. Top Out leo Line FINi►L:
poet/Beam Struot. San. Sewer Framing -Bldg.
Post/ am Meeh. Rain Drain Insulation -Plumb-
-,,
Underfloor Vater Line Gyp. Bd. --Meeh.
Date Requested: j Yl __Time: AM PM
Address: /~7
_LSa� L Permit r:�I
Builder:
T9E FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspec�—APPROV�tt;--�--�iO--ZISAPPROVRD
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APPROVED BUBJECP TO AWVZ '
ll�V/TT' �Call For Reinep.
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INSPECTION NOTICE �Q
City of Tigard Building Department
13123 SA Ball Blvd. Tigard, Oregon 97223 NV/
Inspection Line (Rec-o-Phone)t 639-4115 Business Phones 639-4171
InspectionsI
Footing Plbg. Underelab Neoh. Rough-in Appr/Sdwlk y
Found. Plbg. Top Out vias Line rINALt I
Post/Beam Struct. San. Sewer Framing -.Bldg.
Post/Beam Hach. Rain Drain Insulation, -Plumb.
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Plbg. Underfloor Nater Line Gyp. Rd. -mech.
/
� Date RequeslItedltTimet� �� /�/ 1 �'� AN PK .
Add,-aose l� 1 1 Jar r�t�v� ln_l!l! Permit is -3 `U I f)'S
Builder: �i_.P c'Y1 �t�w�Q j ��( - IO( Lee, ,
THS FOLLOWING CORRECTIONS ARE REQUIREDs
42,
1 Inspectors _ Dates_-_�
APPROVED DISAPtROVED APPROVED SUBJECT TO ABOVE /
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IMBPBCTI011 NOTICE /
City of Tigard Building
13125 dw Ball Blvd. Tigard, Oregon 2,?3'�
jInspection Lina (Rao-O-Phones 639-4175 Businas Phones 639-4171
Inspections —
looting Plbg. UnGerelab Hoch. Rough-in Appr/Sdwlk .
round. Plbg. Top Out Gas Linw FINALs
Post/Beam struct. San. Bower Framing -Bldg.
Post/Beam Nech. Rain Drain Insulation -Plumb.
iFf6g. Underfloor 1 Water Line Gyp. Bd. -Hoch.
Date Roquestods CJ 3 T:mes > -AM PH
Addreass 1 �,' 7 L /d 7 . Permit #s
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Builders
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THE FOLLOWING CORRECTIONS ARE REQUIRED: —
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Inapec't Date�
roti 1 y^: 1�DVBD DI9APPR APPROVE?
a]1 For Aeinep.
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ITY OF TIGARD
CPEit'i'i I o. . . . . M S T
rl1 ;1511 R PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT
13126 9W Hall Blvd.Thud,G(egan 9722398199 (603)839.4171
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UHDIVIGiON. . . « BLI)r-ORD 6L.Liv ZUNIN8 ■
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MIS T'-�3--01 )„3i_11' U OI ITS: l ctEaz•:IN,.h)i:'_N1 . • a . . n • �1 'S � I �
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OF W(.ikK. :NE:W --%L_DRMS.3 BAI1-i5GARAGE. . . e46a 5f
UFUt« t:. . . :;ii i t.•_i:llati �ai2E i�; _._ .._. -•- I-4EQU1 4L Li al:!'IMEACK;a__. _..__..._ .._ ..
Yi-,C UF' CQNS1', a SIV C IRST. . . . . 15 7 sf- LEFT T. - 1� ft RIGHT. 45 f
3l:;C1A,-`Ad+lc Y Girl('. .R:?, .CC LJ1'J).i. . . f 'HUN f . :j-1r4l t t: Iii'All. « ; 13 t
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i.IU1,i'i . . . . . . . . 17 ft f L)-1 I+1 i'�+c r' 'sf 'MNU iL 1J6:.f%_a,'I'CI�, .
1_C7OR LOAD. . . . .40 psf VOLLIi.. . . . . 1 : 7B518 F°ARKIN6 SPACE`'i. , i i
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w._..._. .--- PLUMB 11,1U
lfal;S. . , « . . ., • •. : 1 I l_.CJlJf3 1JF�f�INL;. « . . :0 bAL1,1s"L0W PRE 04TIRS. . :0
WATLR HEATERS. . « a z HAF'ti. . . . . . . .
f..AUt%1l. RY i RPV;-1. . , i i�''l 1 i I3FiEa I'Jf>. . » . . , . •. •?
AA FLA CLUS%_'i;i. . , ._ SEWER LINE (ft ) . Vi URL-ASE TkW- ,. . , . . . . .0
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:;ARBAGE UiSO. . . : i RAIN DRAIN (ft) . ads �(
JtI�+iI.IIUu 110i:FGV 104iN DRAIN ). . . 1
MLCHAN I CAL FILES
Ic.. _ I 'r►=rEw . - _.._._ _..._. ._.. UNI•T HTR15. ., .:0 1;yF,rLn amnl_trit by date
VENTS . . . . , .0 E:IPRT fi 3/:�. 00 JLH o:,/:sl/�J.',
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URN r 100K . 1 f1UODS. . . . . . . 1 b5PC. $ ir, 51b JH (A41+-7/93
UfiPJ ) e 1k'•tllh: , . .+11 WOUL)bI'OVIi-S. -.0 Itllw10, t 1 k-171 JIA 04/'i:7/1'),:,
Li:OR F'URN. . . , ;1b CLU DRYERS. : 1 111 Sc $ '',5. V10 Jf1 04/227/1)
iJ1L/ :.Mrs ( :31-IFI-.0 C:1T I'If. ti UNITS; '1 illPftf' 11 ,11!
0944 (JUl"1_LA 1,: 1 11'PLL $ 11.'x. :1 vi JH 04/27/9,:,
)wr;r3r a _..._.. .• . _ ..._ ..... _ 1, rF .. 4 _ O° -) JFi Ib4/21.19
1,15. 00 JH 04/87/9,5
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'hone #: �i24- l 199
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msfier>ttt :u iae.pd subject ' the reguia+;ons contair,ec it Nae ___ ._. .... .... +G.GILI1a{EI) lhifir`'1:k, I iLINE3 _ -
t'jart Aunicl�;a. uds, :tete c ure. Speeta:ty ,odes ane w.ii other r=oot/fo{.Irlc) 1(7i3N Fireplace lri,.,p
olf•cab'Ya idt:, ar.: ,11) '1e done in ar_I_nroance with approved Pcst;/Beram ; tr uC1, GuA , Line ;Cusp
�1ans. .'his peva t. -11, expire J xorN is not 5116 its Mec:ha:t -,w
syl Of issuetice, .I• if wort. / Plmi1-inrtsslab Inafa Gyp 1?uArd lro,,p
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13175 SW Hall DMi PLNCK/RECT #
CITY 01AF TI GA.RD93-
COMMUNITY
DEVELOPMENT DEPARTMENT Tipcd.Orc6an9721� PERMIT 0 �I?5f o/�s
501 6394171 _
� � DATE ISSUED �
JOB ADDRESS: . 1�Sr1Eti• JOi A�1 Wi�"1 _ TAX MAP/LOT
SUB: r_4e.,o, LOT: 03 LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME:
REISSUE OF: _ l
ADDRESS: -T-7,Q- lellaX LAST REISSUE: _—
`, FLOOD PLAIN/ s
PHONE: _ SENSITIVE LAND:
CONTRACTOR APPROVALS RE VIREO
NAME: PLANNING: 7%
ADDRESS: i? -Plow ENGINEERING:
—q-1 C)0-1 FIRE DEPT:
PHONE: X7-4'^ 1 OTHER: _
CONTR. BOARD #: -10q gZ.- _ EXP DATE:
II ITEMS REQUIRED /-
SUBCONTRACTORS: PLUMB: _� _ _ LIST/SUBCONTRACTORS.
. �� MECH: BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: M VN c.*,j pr-x- C • TRUSS DETAILS:
ADDRESS: 1102� t,,uj• U-YtI.Z � A1C _ OTHER:
PHONE:
PROPOSED BLDG. USE: _�11`►& Lk-- kV-A F�e5 wV1t1`tj17-;t– —
COMMENTS: _ _��P � ���.��y
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APPLI NT SIGN RE
Received By: __ C _ _ Date Received: �>
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PERMIT # ACCT # DES-AIPTION AMOUNT AMOUNT PD. BAL. DUE
,f-_4195' 10-432 00 Building Permit Fees 7uCr/
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 Ol State Building Tax (5%) A 6• ,= � ��'
Building 5�r�
Plumbing ?)
Mechanical cy3
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10-433 rJ Plans Check Fee �>f 3 L� �'t
Building
Plumbing
i
Mechanical
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 Instit,itional TIF Fees
25-448-03 Office TIF Fees _
25-448-01 Residential Traffic Fees
25-448-05 Piss 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 QuLntity (Fee in lieu of)
TOTAL
nm/3587P.WPF
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C TTY Wi I CARD RECEIP'I OF PAYMENT RECEIPT NO. 193-~�:3`�4 y5.
CHECK AMOUNT s 412. 41
+I NAME. s BEACON HOME'Gi CASH AMOUNT s 0. 0 er" ■
ADDRESS a PAYMENT DATE a O4/07/93 '
SUBDIVISION
I
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE: OF POY14ENT AMOUNT PAID
136ILDING PERM 160. 00 PLUMBING PERM 125.1 OO �
MECHANICAL PE 40. 50 ST. SU I L.D PER 26. 78
PLAN CHECK FF_. 25. 13 SEWI:':"R INSPE'C'T 305. 00
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L.OT 63 P DFORD G1_.EN
it t677:; SW JORDPNI WHY
1�
TOTAL. AMOUNT PAID 4t2. 41
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1.
C;T 1'Y (:)F' T J GARD RE:GE.I VIT OF ('lNYMFNT RECEIPT NO. a 93•-238461
CHECK AMOUNT 1 '750: 00
NAME a 6E'PC:ON HOMES INC CASH AMOUNT 1 1/1. 00
ADDRESS 1 1903 NW 169TH PLAr,F: PAYMENT DATE. s 03/31/93
BEAVE ETON, OR SUBDIVISION o.
9"l�►Q��+_ ,
PI. PPP E OF PAYME:NT AMClUNT PAIL) PURPOSE' OF PAYMENT AMOUNT PAIC1
PLAN CsHF..CK FF 3-9:38 P700. O0 PL (41\1 CHECK FF 3-94Ft 40. 00
BUILDING PERM .3•-94R a:10. 00 rL.AN ('_AAECK FE 7,--95R 40. 00
BUILDING PERM 3-955 C'10' 00
IP-311 •JORDON, 1_01' 11 JORDON WAY, LOT 38s 12?0b
:10RDON WAY, LOT 63
tOTAI_ AMOUNT MAID --. — — —> 750. 00
V �.
/
uniiled
� sewerage SAN ITARY� PITH
Ufa envy .N. First Ave.,Suits 270,Hillsboro,Or.,87124 SURFACEWATER
503 048.8621
z CONNECTION C'UMIT
ISSUE DATE: 042'/173 FXPIRATION DATE 1.02493 PERMIT 104001,
STRUCTURE ADDRFSG 16773 PROJECT' 1908
STRUCTURE STREET Std ,.JORDAN WAY
1-01 63 BT OCK
rY'E'I':; CONNECTION- NEW OFBEDF'0r f'LEN NO . 1
1 YPE INSTALLATION- ( 19) BLD SWR/ERO C014/43LIC !
TYPl:; 0(,1;IJPANCY - ( I ) `INOLC FAMILY PARCF'L '23t 16 AD 29"'00
OTR SEC 471.6 MH l lt0"I/ ■
OWMF;R BEACON DOME=S
AUDRES`; PO BOX 13611 TRE'ATMENT . E'1.ANT FIURFI()N
BEAVERTIIN OR .97075
F'Wf.)NE 524--1999 JURIS•'D KING CITY
F7:XTURE............_..._......_....EQUIVALENT ... ..... . .. . [iWkJ..LINC _...._... .. _. .. .......... ..................._.. __. . ..
.. ......... ....... ..... ......
PE'B'lrIENT1AL.
UNI'rs SERVICE UNITS 0.0 UNITS 1 FiERVICE UNI rS I
CONNrcTION FETES SUR'l- ACE WATER DEVELOPMENT FF E'S
SLWER (.ONw::c'rt0N 2100 .00 WAT'F:R QUALITY 180.00
r LESG CREDIT 1 F10 . 00:;
WATER OIJANTi'.TY 1U0. 00
LESS CREDIT 0, 00::
ER03' 10 N C0NTR0L
k INSPECTION 40. 00
FLAN 0111 CK 26. 00
SUBT O1 AL. 2100100 SUBTO I'AL 166 . 00
TOTAL 2266400
r AFTI. NAME r'rTl.::R I;IJY,K Pl�la�lr ..................._..._. .._
AFFIL.LIATION VP
RTMARKS F'ROJ*tgo )--lir-iir0RTi GLEN - LIT # 63
*2'4 HOUR NOTICV: rnR ETR BION CONTROL INSPECTION;: REQUIRED
SIGNATURErr
_.. .......-5/. --._..._._--._..._..— _. _ - _.. ISSUED 11Y TIIOMrsoN.IA
Permit 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 no. l,uated at the
measurement yeven, the installer shall prospect three feet in all directions from the distance given. if not so located, the
installer shall purchase a "Tap and Side Sewer" Permit at the current charge and the Agency will install a lateral.
6/90 WHITB — USA, SLUE — Accounting, GREEN —Inepectinn, YELLOW — customer
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CITY SAX NO-503 639-3771 0800 P11
o 7/
CITY 9 ..or 83KING
� 15300SW.116th Avenue,King laity,Oregon 5TZ24 Phone:639.40212
' COMMUNITY DEVELOPMENT ■
APPLIC..TION FOR BUILDING PERMIT
(Instructions on reverse)
DATE -9S
1. NAME OF APDL I _ - &—en,mI N d%me No. 5 z y ✓9'9 9
ADDRESS:
ADDRESS OF a1ROF�OSED
2. TYPE OF CHANGE, IMpROVEKENT OR CONSTRUCTION FOR WHICH PERMIT IS REQUES'T'ED.
DFZYCRIBE BRIEFLY - ATTACH TWOPIES OF PLANS OR DdiAlryINGS OF
S®
PROPOPROJWr• '1'?9 u 9;�-y
l a
3. NAME AND ADDRESS OF CONTRA --
�_ PHONE N0. LICTIVSE N0. 274Cl
4. NEIGHBORS WHQ MAY BE AFFECTED 13Y THIS PROJECT WILL BE NOTIFIED 13Y TIM CITY.
5. APPLICANT OR HER/HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING COrKISSION
MEETING NEXT HELD ON
REPRESENTATIVES NAME` PHONE NO.,�.
(The Ding Citi Planaioa Coes ioo r c:nsider only those applications received at least Eine (5) dais
Prior to a Meeting.
K SIGNATURE
*******�****�**�a<�**:�*�**ir** ***�►k*****,k******�t,k*�*st****��*,tit*�t*e,t*err*r►**,rr,rrr*,e***
APPLICATTON RECEIVED BY --- )AT& `y 7—
APPLICABLE FEE RECEIVED $ TOTAL
PLANNING 0OW1SSI DECISION: "roved
.. Denied-
CMITIONS (.J
roved appl' ations 8,J valid for ail months�Ohl y
Signatur
Date
10TI; Or on Baaabatldeca Lu reg ices that all persons vho contract tar cork an their resiOence be
registered lith the Builders Board which veins the contractor is bonded and insured on the job site.
for your ^,!otection, be certain your contractor is registered by calling City Ball ph: 689.4082.
NOTE: A permit must also be obtained om the City of Tigard Department of
Carminity Develop imm t Yes_ No —
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CITY OF TIGARD INSPECTION REPORT
The above listed p eject has been inspected and Approved tied
Daae Cam ents
3igraatul:e
(9..+.GUAq bs.Apactdr. p190A . 00AWL On& 111 copy to K,i.RA U41
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'JUN-t4- 7 14 MCITY JF k?Nta CITY FAX N0:503 639-3771 aE00 P15
01
G.3
KING CITY %•'!5T 9 3 - '61 4 S •
15300 S.W.116th Avenue,King City,Oregon 97224 Phone:639.4082
COMMUNIT. DEVELOPMENT ■
APPLICATION FOR BUILDING PERMIT
(Instructions an reverse)
DATE V- 22- 9.3
1. NAME OF APPLICANT: Phone No. S-; /—/9 9 2
ADDRESS:.�P - . f=.� _.
Amens Or PRo>o , •�, _ ,:� 411&AA.
2. TYPE OF CHANGE, IMIW4E 4 NT OR CONSTRUCTION FOR WHICH PERM',-T IS REWESTED.
DESCRIBE 3RIEFLY - ATTACH TWO COPIF.: OF PLANS OR DRAWINGS OF
PROPOSED PROJECT: y?"'.)
3. NAME AND ADDRESS OF QOPITRACPOR �n r.o - '�r� vo
PHONE NO. *'CENSE NO. t1S
4. NEIL BOBS WHO MAY BE Arr`E= BY THIS PROJECT WI4� BE NOTIFIED BY THE CITY.
5. APPLICANT OR HER/HIS REPRESFNTATI1iE MUST BE PRESENT AT THE PLANNING COWISSION
HWING NEXT HELD ON _
REPRESENTATIVES NAME P1fONLr NO.
(The Ring City Planning Co ission r' 1 consider only those applications received at least live (5) days
prior to a aeeti 4
SI"-W.RE
APPLICATION RECEIVED BY DATE
APPLICABLE' FEE F=IVED $ �50�` TnTAL� �'GP
PLANNING CCHMISSION DECISION: Approv Denied
CONDITIONS
roved appl'catians are valid for six months only
Signature Date
TOTE: egon Boltebuilderr Lae requires that all persons oho contract for wort on their residence be
registered eith the 9oildcrs Board which means the contractor is bonded and insured on tho job site.
Pot your protection, be certain your contractor is registered by calling City gall Ph: 639-1092.
NM: A permit oust also ' e obtained from the City of Tigard Department of
Catnamity Development Yes _ No x
CITY OF TIGARD INSP87 ION REPORT
The above listed project has been inspected and Approved ____Denied
Date Camments
Signature
(ALi.UIRe Ampeati t pCea Am jwAwu, outs` (1) copy to K4m r44)
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