10250 SW KABLE STREET I
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APPROVED Vo'R CONSTRUCTION
CIT`! OF TIGARD 1
PERMIT NO• go�_,2 Y -- SITE ADDRESS_l�' • 57'.•_..`'.,/r i.//. I
DATE --<o_ 4 �►di•'y't�; � ,, �
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NOTE: IF THIS MICROFILMED I 2 3 4 5 6 7 8 9 I0 I I— 1?
DRAWING iS LESS CLEAR THAN k
THIS NOTICE;-'IT IS DUE To
y... THE QUALITY OF THE ORIGINAL
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MAY 7
1992
10250 SW KABLE STREET
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F311'1 0 T'NG PEPM11
FIEPMNO. : BIMOOW-2a
CITY OF �'��RD i,41
CITYCr tWAVO
COMMUNITY DEVELOPMENT DEPARTMENT JalOON
DA'VE :1j%c'%LJE:0 : Al/ 111/8H
13125 S N Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)619-4175 PPIM . 1*)M'T .NO . 0-1130628
11011--i ADINAH:SS : 1.W.'.50 !:;W KAHI F. 5*T*
IAX 1,721 5UH : I T' : UK :
I AND kAsE :
1.1111 53'.ZEE : VAI UA TT(.')N : th 1 ,992
FAONT' : PEAP:
W014K CLAS93 : AEPAJJT DWE-A L . UN 1:'T!3 : LEI*-'T* : RT(,H'T' :
LN)E 'T'YF)F:: 5XNGI-F.' F AM TA Y NO. BF14400M!, EXT .WALA C.0NS1' :
(:',UNS'T . 1'Yl'F..: VN NO . PA'TIA!i : N E.: W
()CCUP , P3 1*440'11' .()PEN1N(.;5 :
(:)(:%UP. 11-113AD N
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11"YVAL AWKA:
N0 . S11:11PIES: 15 T : POOF G0N5'1': FXPE RE'T"?
PND: Ant:'At KWTFA) :
314D! (:)C(:tJF). NF'PAP? RA'T*FD:
MEZZANINE:? I.Wili:M' 'T
FA 0JR LOAD: 10 F'TPE: SPIM-P7 ALAPM'?
FA ()w ("IPM) D F.'I'E.,C"T 7
HFAT' I-4101CV) . AUGE:1:1 ci'? COPP7
F.'LAN CHECK BY : rit
AIEMAPKS :
i9.1.1 +cir frainim.4 RE;.*1L5tAJr-'- OF NO .
I AST' ISE X5511JE
0 Tarot CI cl r-r, 111:3''.'3 0
W 10250 111W r)LAIJ REVIEW
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E tigati-cl 1:11, F X P r--' D E.:P 7
PHONE", (50.3) 639-11.00 5T A'7'F:. 1A X
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1)1-*V F.L.0I::'MF:.N I' (.,'HAl-*4(.A'-..S
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M(.k.JN'T'AI:N DUN 51)('.:
MOUNTATN (,-,r:::NEPAL. ('01S51*111IR"I'TON
T EW( !5'T PCIE'll
R DI S*T*
A wp)"It E)r 9"?068 PPEPATID < $34 . 1*15)
C
T PHONE M0'3) 655 ;3566
0 PF.*-:GX15*1'PA'T:E0N W.). W1736
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PI'-A"P:JPT' W.) .
Phis permit is issued subject to the rpgulatio,7s contained it)Title 14 •••••-••••• ..........................
of the TIVIC, State of Oregon Specialty Codes,zoning regulations TISISPECIJOINIS
and all other applicable codes and ordinan,-qs. and It is hereby IF PAM'I'M3
agreed that the work will be dome in accordar%o with the plains and
specifications and In compliance with LI! applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have Current city
tax permits This permit will expire And become null end
old If woi�Is not started within 180 days.or If wnrl(is suspended or
ahandoned for a period of 180 days any time aflir work has
r ommenced.It shall be the responsibility of the permittee to assure
till required Inspections are requested and approved
Pi!r m a Signature`
Issu^ri I;,.. INGPIRL."11TUN AA9-4115--r-
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
_JUN Z_AN
C11YOFTIGARD PLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT SCRUM PLAN CHECK
13125 SW FW 6Wd P.o.1la2x.W,TlOKa g*n V? 1(503)=4176 PERMIT E
DATE ISSUED = r�
JOB ADDRESS: C [IL z,e , �L-t `i TAX MAP/LOT x 1-T 7 2
SUB: LOT: LAND USE:
VALUATION: SETBACKS: FRONT: REAR: LEFT: RIGHT:
WORK CLASS: HEIGHT: TOTAL AREA: -2 t,-z4
USE TYPE: FLOOR LOAD. 1ST:
CONSTR TYPE: HEAT TYPE: 2ND:
OCCUP GROUP: DWELL/UNITS- 3RLw-
OCCUP LOAD: NO BEDROOAS: _ P&SEM-NT: _
NO STORIES: NO BATHS: GARAGE:
IMP SURFACE: —"
APPROVALS REQ-D SPEC?.AL NOTES ITEMS REQUIRED
PLANNING: REISSUE OF: LIST SUBCONTRACTORS- Cl/ ',C
ENGINEERING: LAST REISSUE: BUS TAX:
FIRE DEPT.: FLOOD PLAIN/ CALCULATIONS;
OTHER. SEN LIiD.: TRUSS DETAILS:
PARKING PLAN: �—
LANDSCAPE PLAN:
PLAN CHECK BY: OTHER:
COMMENTS:
Gr-, L_ --
L /''
ACCT—# — DESEUPTION AMOUNT
OWNER 10-432 Building Permit Fees S 4.
NAME: J, 4 10-431-600 Plu abing Permit Fees
ADDRESS. — _ 10-431-601 NP::hanical Permit Fees
10-230-501 State Building Tax (5x)
10-433 Plans Check Fee
Ll PHONE: ., _ 30-443 Sewer Connection (20X) t
30-202 Sewer Connection (802) S
CONTRACTOR 30-444 Sewer Inspection
NAME:- .51-448 Street System Dev. Charge (SDC) �^ _
ADDRESS: '52-449-610 Parke I System Dev. Charge (PDC) �
` '' 'L 52-449-620 Parke II System Dev. Charge (PDC) _
_.' 31-450 Storm Drainage Syqt Dev Chrg(SSDC) _
HONE: - � 10-230•-505 TRFD (952) _
r, 10-435 TRFD (52)
ARCH/ENGINEER 1.0-230-506 Washington County Fire 01 (95x) _
NAME: 16-435 Washington County Fire /1 (52)
ADDRESS: 10-220 Amart/Wedgewood = J
PHONE: TOTAL
PREPAID
REC N_ ?�
BALANCE DUE
APPLICANT SIGNATURE
,ceived By: _ _ Date Received:
ERMA I I I
INSPECTION NOTICE
City of Tigard Building Depbrtment
12.420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Time
Date Requested-
Permit
Address
�Dwner Lot
Builder
The following Building Cede deficiencias are required to be corrected,
Presented to Approved
Disapproved
Inspector
Date
CALL FOR REINSPECTION
YES 11 NO
EJL..A a. ■a
SEWER PERMIT
Unified Sewerage Agency
of Washington County CITY OF 'A 2 DATE
OWNER s - � �--� � �-7>2 _ _ PHONE,�_3
OWNER 'S ADDRESS, CO.Z,S42.1
TYPE OF INSTALLATION,
SIDE SEWER ❑ LINE 10AP AND SIDE SEWER 0 LINE TAP
T'Yr' - OF OCCUPANCY r
❑ NEW Ea EXISTING ❑ SINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7-1-70 : ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF STRUCTURE ,
Permit Conditions: :'he applicant agree! to comply with sh F les snd raa;jlations of the Unified Sewerage Agency.
When calling for Inspection, please refer to the Permit Number. The Application expires In one hundred twenty (120)
days. The amount paid will be forfeited should expiration occur.
The Agency does not guarantee the accuracy of i;ie location of side sewer laterals. If the sewer Is not located at
the measurement given, the Installer shall prospect three feet In all directions from the distance and depth 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 at the location specified by the Installer.
1 FEES,
PERMIT FEE S
CONNECTION CHARGE
LINE TAP INSTALLATION
ISSUED BY
OTHER
TOTAL a- C7
APPLICANT DATE
SEINER PERMIT
ADDRESS OF STRUCTURE ,/, '''` _`' `? -"'�<,,- ' -- . -
7AX MAP ...�..�/ /i�C TAX LOT / / _ SY3TEM w o
LOT _.._ BLOCK nF
P✓ r
APPROVED BY DATE ISSUED BY DATE
D. U. 'S .__ _ REMARKS enL'N
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