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INSPECTION NOTICE
City of Tigard Building Department
P 0. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection (7
Date Requested (171.2VP�j Time A.M. P.M.
Address Permit
Owner L.,
The following Building Code deficiencies are required to be corrected:
7-
L
Presented to Approved
Hspector 00isapproved
Date
CALL FOR REINSPECTION
0 YE8 0 No
1WPECTION NOTICE
City of Tigard Building ET epartment
P.O. Box 23397 CU
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection a
Date Requested Time� A.M�(O��P.M.
Address Permit
ow .!f Lot #
Buil
The following Building Code deficiencies ere required to be corrected:
r
Presented to Approved
Inspertor Disapproved
Date
CALL FOR REINSPECTION
❑ YES E3 NO
CIT Y OF T16A RD Pl.A.JMDIN(*.; PEPM]"T
CITY -wqv FIE. NO. P11-861.130
I
COMMUNITY DEVELOPMENT DEPARTMENT o"oo"
13125 S.W Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223.(503)639-4175 74
CWTE.' 15SUED 6/13/68
JOB Al)l*.)Pr:-*-*SS : 1.06130 '.SW Kr.-:-*N'T' 5'1'
'T AX MAP/LU1' 12SI. 15AA 2Y00 SUB; 0()Vl---P LANDING 1...1' : 60 HK
LAND W-511E: P1111 .5pD
L..(:)1' !`;TZE :
I'TEM: NO: NO:
WORK CLA! WATER CLOWT 3 'TRAP
UGE 'TYPE FAMILY URINAL P'-! LOW PPVN1'R
CION51' .I*YPE : "I LAVOPA'tORY OAP PW ME P
Dit"C'UP . ('."Rp . P3 TUB SHOWER L',REASE'. 'TRP05
DlIiHWASHEP 1.
GARBAGE: DISPOSAL I
N(:) . !:i I(:)14:1.E S 2. WASHING MAGHINLI
DWELA. .UNI115 : 1. LAUNDRY 'TRAY OLDG,. I)PAIN (01A
FLUOP I)PAIN
GINK 1. SEW 1-1 (F'T
WA'T'ER HEATE-31 S 1*0 n ti w A vN F T. 1.
(YT HE
F*EES
W
N MILLER JAY PFOMI'T $1.417 0
E P . u , ROX 23291.
R I'TGAPI.) OR 9*7223 FJX'1'UPlE'5
PIAONW'_" (503) SIWIE I'AX $7 .38
C O'THEP
0
N WA,T*,I,S K E*N
T
R KEN WA'T'TS PLUMBING
A
C Pa HUX 230925
T tigurd til- 972P3
0
R PHONE: (503) 6134--66P-6
NO, 1404764 1 OTAL: $1.54.SH
This permit is issued subject to the regi.1100118 contained in Title 14 RECEIPT NO ,
of the TMC, State of Oregon Specialty Codes, zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will he done In accordance with the plans and PE.QUIPE.0 IN!3PE(-1'I(:)NS
specifications and In compliance with all applicable codes and PI H.UNDEP51 AR
ordinances The issuance of this permit does not waive restrictive P0151' & DE AM
covenants Contactor and subcontractors shall have current city WATER LINE
business tax prirmits. This permit will expire and become null and P . I'OPOIUT
void if work Is not started within 180 days,or if work is suspended or
abandoned for a period of 180 days any time after work has RATN ()RATN5
commenced. it shall be the responsibility of the permittee to assure r-:*.t NAL
all required inspections are requested and approved
Permittee Signature
Issued By
(".ol—r-- FOR TN.;PFJ"'VTON 639----11.7!5
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PRTMJ)M'T' .NO, 881129
At 'J Mk'-'8C 13
Pl�- �Ml T* NU. : MI'.'-'8C 1.
CITY OF TIGA RD CW��
COMMUNITY DEVELOPMENT DEPARTMENT DATE 155UED: 6 13 88
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223,(503)639-4175
J01i", ADDRESS : 10600 SW KENT 51'
'TAX MAP/I...01 25.1, 15AA 2.900 SUB: DOVER I-ANDING. L.1 68 [fl<
I-AND USIH: : Ple4. 3PD
1 O'T SIZE:
I*TEM: NO: No
W0I--4K ('.ILASS ; NEW FURNACF:: <100K AIR HANDL.P <10
USE 'T*Yl:)F*..: SINGLE- FAMILY F"UPNACE 10OK4- I All"' FIANDLJ'- 1.01K
CON!61* . *TYPE: VN FLOOR FURNACE EV, d .GOOL EP
OCICUP. GPIP. : R3 HEA'TEP VENI' FON 6
Vl-:N*T VEN1' . SY5'TL-:M
RL-Ph"UM11) C.311-11P HOOD 1
NO. STORIES : is BL.R/C'(:)MP 1 INIC."I NE PAI'014 11 Df-')M
UWFAA. . UNII'S : 1. 1-31-1:4/11,101VIP 1.5--30HP INCINF-44ATUR(CUM
VIff-l-L. TYPE GAS BL.R/COM 1---1 30-50HP RI-F.PAIR UNITS
MAX . JAPUT 81...R/LOMP 504-HP LYT Hli:.14 P
FlPE DMPP57 GAS PIPING UU1*L-E'tS 1.
HJI.AA PPLKS57
I OW F)RES57
RE.'MARKS :
M:I!LI EN JAY V'EPM1*T* 11111.0 .0101
N P . BOX 23P91. I'1-AN PEVIEW $1.2.75
E 1'i(.AI711) (114 97x.'.23 FJX*11jPkS $111 . 00
C)I--IONr.:: (5 03) 694-4!5-13 �-il'Al*r--.' I A 4i P. 15 5
0,11-4ER
C
0 HE 1.)1.N PUBF-144,
N HEA'rJ:N(;
T
R 845 NW 231S'11'
A
C hills;brira mr. 97123
T PHONE (50 3) 648-11.59
0
NO . 172j.1 TOTAL : $66
PECE-111DI' NU
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes. zoning regulations INSPr-KC11ONS
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and GAS LINE'
specifications and in compliance with all applicable codes and POST PFAM
ordinances The issuance of this permit does not waive restrictive I7(AK31-11 IN
covenants Contractor and subcontractors shall a current city F".1 NAL
business tax permits This permit will expire and ' � ome null and
void If work is not started within 180 days,or If-irk is suspen,.ed or
abandoned for a period of 180 days a.ty time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
a r A
Permittee Slgnatcl—e�
Issued By lliAl.+. 143R INSPE61146114 eliiy A*:FL*l
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
B- II-111 011 NG V%.:PM'I T
CITY OF T167A RD PERM I T NO. : BIA30 3.1.P9
CmrIID
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 6/1.a/(38
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223,i303)639-4175 PAim. PmT.NO. 881129
JOH ADUPESS : 1,0680 SW KENT
I'AX MAP/1-01' VlAA 2900 WB: DOVER LAW.)lNG LT : 6H HK :
I (Ty' !:0,ZE : VAI UA T 3:ON: 1p 91 1.65 SETBACKS
FRONT: 20 1:111-i:AP : 6
WORK (:',LA55 : NEW DWEI L .UNITS : I LEFT: 6 I' 1GI-111 : 4"
UF.-AK TY1".0E: 51NG3-I-'- FOM1.1 Y NO. BEDROOMS : 3 EXT .WALI CONS*]' :
GON%T . TYPE:: : VN NO. DA VHS : 3 N S . E W
(a=1W.) .GRP . : P3 PAU'l . 0PEN1NG5 :
OGCUI--l.LOAD N S. E W
TOTAL. APF.A : 2060
NO . SIT)PIES . P :1511' : 11.2.26 ROOF GONST: I.- FIRE PET
HEV'.-',H'T' : 4'20 2NI*.) : 8444 APLA SEPAR"t RAT'F.W:
BAFiF-':Ml5:NT7 J- PI) . OU:,W). 5I'--"PAA7 PATEU:
MEZZANINIH.7 BASEM' 'T
FLOOR LOOD: 40 GAPAGE : 440 FIRE LjPPKLn7 ALARM?
FLUW 4(::PM) DK'TE(�T ? Yk;*.!s
TYPE: GAS !-!UGI'-) .ACCI:`iS'? CORP'?
PLAN BY : r3A
REMARKS :
Pli-KISSILIE. 01" NO. 870219
LAST REISSUE. 880339
F-
0 MILI L.N JAY
W PEWMIT $409.00
N 11 . t) , "OX c232191 PLAN PKVIEW 1111'e10 . 00
R E T1GAPI) OR 97223 F1114E
PHUNI-i'. (503) 68,ei--7,5413 STA'T'E: I AX
OTHI'.*:P
C Ur-E.VELOPME'N'T CHAP(3EL)
0 MIA..LEP JAY SDC% STOPM) $250.00
N
T JAY Mll.-L..I;-.'P B5LsT
UTI—DEP 0C,I PEET) $600 . 00
R r.) . a . BOX 23291 Pi'.)1111 I#P.. 11 $250 .00
A
C TIGAPD On 9,7223 1:*-'PEPA10 111111140 . 00)
T r*ll 100111=, (503) bE14-75413
0
R F-'T.
A ,1WFPATX0N NO. 301.09 TOTAL: 1111. '541
29 . 11.115
RECEIPT NO. 3
11 Permit is isrued s jbiect to the regulations contained in Title 14
of tf,eTMC, Su to of Oregon Specialty Codes.zoning regulations 1:11EQUIRED INSPECT1ONG
and all other applicable codes and ordinances. and it is hereby
agreed that the work will be done in accordance with the plans and FWTVINC.
specillcRtions and In compliance with all applicable codes and I:-'01.1NDA*T1ON WALI PA114 DRAINS
ordinances The Issuance of this permit does not waive restrictive pll]�.-il & HIEKA,I WAUEP L.LNE
covenants, Contractor and subcontractors shall have current city PLB.UNDF-KC-151—AH CITY APPPCH/SW
business tax permits. This permit will expire and become null and SLAB FINAL
void it work is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has PI...B. TOPOUT
commenced It shall be the responsibility of the permittee to assure F:PAM 1.NG
all required inspections are requested and approved F 1.REPLACE
GAS
IN501—PiTION
Permittee Signatur'�I ' BOANU
Issued By:
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PIE4TM.14' NO. : SEMM.'33
CITY OF TI17A RD
CITYOFTIOARD
COWUNITY DEVELOPMENT DEPARTMENT 00100M P.iSUFf) : 4)/1.3/8a
13125 S W Hall Blvd.P.O Box 23397,Tigard,Oregon 97223.t503)639-4176 PPT h4. PKI, . 1140 11.3 EJ 3.J V y
,A:IF? ADDRIH:E-5: 10630 1514 KEN'T ST U5A NUMUEP: 0,35919
'I AX MAP/1..01' 251 15AA 2900 SLJH: DOVE P LANDTN(.', J*T* : 1"" PIK
I-AND USE : FTS. .5PD
I O'T
5 TWP: 2rn PN(.,: J.w
WORK CLA55 : NEW
USE. 'TYPC-.-. : FAMILY
tc) C.'c)MJ,)3.q With 61.13. 1 1-1.1cl-At iilkncl t hc-� 1.11-11 f:1.Ca(J
'rhe pr,,r-init #.,1?xP:Lr,e!qi 12.0 chity% thci chat", -illiilil Tlrl(p t(itial,
UMMIl'It ll.)oLicl w:L:111. 6P. if the V)c-1I-In:i t V.-T X V; . Thol III-it
Ill.rit*7C4 tl,l(:# 41CICIAT"itc.."I 4:1-P ti-iiii7i lcjt..�atiori (*).F tho, IaLtili?r'llk"Liu . 3'.f t I-I(-it flf*rWw'lr' J.11;
Iit-it :1cIr!J;1tWcI al.t. LI'Icl qivc.-tri , t I-i*1 1.rivitia.1.1cir fill-IffiI.I. 3 f r%,c,�t a.rl
dir'ec�ticlll!ll thr.--it q:l.verl . If I-Ifit infj 1(.eft tlPIC) , thivo
"I"a1r) kilrd 5e.)Wc+r'.. Peu*mit jits-ml the AU*Aric!W w:1.13. III T ilk tc-pi"Ift].
IN5TALL. . TYPE : BUILDING liEWER IMPI;:.F-11VIOUS ARIE'IN
I'*-A'.XTUr'**: UNITS : 11 F'NAN'T 3 MIPPOVKM;:N'T :
DWELLING, UNITS : 1.
NO. OF' BI DG5 . 1.
I-En JAY 11111315 . 00
W
MIL F E'E S
PERMIT
N P . (3 . BOX P3291 CONNECTION CHARGE
ii 'TIGIAPI) OP 97P.P3 LINE TAP INSTAI I. .
PH0Nr-'. (503) 60-1-7313
OTHER
C
0 MI.L L E 1:4 ,,JAY
N
T ,JAY MIA-LE-P BUII OEP
R ROX P3291
A
C OP 97223
T
0
R AEGT�:TRATIUN NO. 301.09 IT)TAL : iii f oo
PECEIPT NO
This permit Is issued subject to the regulations contained In Title 14 ...............
of the TMC, State of Oregon Specialty Codes,zoning regulations REQUIRED INSPECTIONS
and all other applicable codes and ordinances. and it Is hereby
agreed that the work will be done In accordance with the plans and ROUGH--IN
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits. TtIJS permit v.11 expire and become null and
void It work is not started within 1164 days,or If work is suspended or
abandoned for a period of 1SO days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
kJ
Permittee Sign re
Issued By: eAhE
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLAN CHECK APPLICATION
CITYOF TIFARD 1 ,® PLAN CHECK #
CIIYOFTI6ARD PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT oaEoon DATE ISSUED
19125 SW Hri Blvd. P.O.Banc 23397,TpaaW,Oregon 972x1(5091839.4175 —�
Joe ADDRESS: 5.n, k", / 5- TAX MAP/LOT
SUB: VV VP. Lc1 ir` LOT: ( 8 _ LAND USE:
VALUATION
OWNER SPECIAL. NOTES_
NAME: _ _ REISSUE OF
ADDRESS: LAST REISSUE:
FLOW PLAIN/
_ SENSITIVE LAND:
PHONE: _ _ _
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: _� PY Ig I -�'1 C ENGINEERING:
ADDRESS: FIRE DEPT
r d _ OTHER:
PHONL: 6 1. ITEMS REQUIRED
LIST/SUBCONTRACTORS: _
ARCH/ENGINEER BU^ TAX: _
NAME: ME CALCULATIONS:
ADDRESS: _ _ TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PHONE: OTHER: __ ^
COMMENTS:
PERMIT N ACCT # DESCRIPIION AMOUNT AMOUNT PD. BAL. DUE
?1)-41 10--432 00 Building Permit Fees U'
�Sb l! 3 t1 10-431 00 Plumbing Permit Fees a 401 —
�� "I
10-431 01 Mechanical Permit Fees ,4v ti 1. v
10--230 01 State Building Tax (5%)
Building 2 a,q :
Plumbing _ /13 i�
Mech 3.,S y _
10-433 00 Plans Check Fee .572. -74-
Building
7 Building
Plumbing
Mech 7
30-443 00 Sewer Connection (20%)
30-202 00 Sewer Connection (80%)
30-444 OU Sewer Inspection S : �
51--448 00 Street System Dev Charge (SDC)
52-449 01 Parks J System Dov Charge (PI)C) .-
52-449 02 Parks II System Dc„ Charyo (PDC) ;L ,j U 1,5 U
31-450 00 Storm Drainage Syst Uev Chrg (S SDC)
10-230 09 'RFD (95%) r ` �
10-435 00 TRFD (5%) ---
10-230 06 Washington County Fire #1 (95%)
10-435 00 Washington Co,..nty Fire #1 (5%)
10-220 00 Amart/Wed3ewood -
TOTAI 4� �
REC 11
APPI TORE
I, r
Received By: 1J Dote Received: �Z