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CITY OF TIGARD BUILDING INSPECTION NOTICE
inspection Line (Rer.-O-Pnone): 639-4175 Business Phone: 6 171
Inspection:_
Footing Susp. CeilingSprink. Rough in Appr/Sdwlk
Foundation Plug, Underslab Mech. Rough-in Frrolace
Pest/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line �B
{ Plbg. Underf,aorRain Drain Framing Plurnb.
Alarm Water Line Insulation Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect
r Date Requested: 4? i�2 <>�cj _Time: AM PM
■
Address: c�✓ E._ _ ���,
' II Builder: Gr!o (o 2 rl ✓ 6-Tz, (:://Permit #id
THE FOLLOWING COR!"iECTION i ARE REQUIRED:
1
Ins ector: Date. ,,124
APPROVED DISAPPROVED _APPROVED SUBJECT TO LOVE
_Call For Reinsp.
_...,.....,....-e..l... .. - .....,_...v..r..0 0.�Yk.��iym Y µ`
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspoction Line (Rec-O-Phone): 639-4175 Business Phone: 63 1171 i
�� nc�2
Inspection: [�
otin Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb
Alarm Water Line Insulation -Mech.
Underfir. Insul, Shear Wall Gyp. Bd -Elect.
Date Requested: 6 S Time: _AM PM
Address:_ a1 �� _.�1'e;—ze,
Builder: Permit
#:�.`� �
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
Inspector. ---' Date:–�5�=��
LAII�PROVED DISAPPROVED —APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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'CON, AITY DEVELOPMENT DEPARTMENT 1='EFttdl : s. . . . . . . :
13125 SAI Hall Blvd.Tigard,Orpon 97293.8109 (503)039-4171 DATE
PARCEL : 2S 1 10CC--_12+40►
Q--C—�O
SO KING GEORGE DRSUBDIVISION. . . . / ZONING:E�LCICK. . . . . . . . . . . I . . . . . . . .
Rii.ISSUE: i'-L.(JQi7 AREAS--..----.--- -._ EXTERIOR WALL CON131'RUCTIt'N
GLASS OF' WURIS. :ALT FIRST. . . . : 144 s f N: S: E: W.-
TYPE
sTYPE O USE. . . :SF= SECOND- -- : ,f PROI E:C1'
!'Yl.-,L OF LUNST. :5N THIRD. . . . : sf N: Ss C: W:
OCCUPANCY GRP. :R3 .1.0TAL--..-•--_- -: t 44 r f ROOF CONST: FIRE RET ? s �
OCCUPANCY LOAD: BASEMENT*. : ,,f AREA SEP. RATED:
TOR. : 1 1-11. : 12 Ft GARAGE_". . . : s 1= OCCU 'SEP. FRA'Tf; D,- 1
B5M1 ?e MEZZ 7 o RLUD
FLOOR LOAD . . . :40 p t I-Lf f :6 -Ft RGHI' : f't FI R SPKL: SMOK DE'T. . s
DWELLING UNIT:. : F k W ft REAR: ft F=IR ALRM: HNDICV1 ACCs
BEDRMS.. L3A'I'HS: IMP SURFACE: =Eta CORR: PARK INGi
VALUE. $ : 75101171
Remar-kms ENCLOSING PA1'IG N01 TO BE. USF:.D AS A HABI"TADLE ARE..:A
tOwner-. ••• - -- - -._...___..___._..__._._.-__._._.___._.._..__........__....__.._._ __ ...____.__._..._..__. FEES
IEU RAISAG type aiacaLrnt by date r^ecpt
i '.386 SW KING GEORGE PRINT' + 66. 50 SW 03/LA'7 `.i •-
PLCK $ 44. 53 K A R 01/e6/95 95--C.01016
KING CITY OR 9j7LL-:4 5PCI 'l :3. 4;3 SW 03/k17/9 -- I
F'7ane #: 620--8391
a
Contracwor: __.-.__-.___.__._.___.___.____._._.._._____..._
NORTHWEST FTNI H
65L/ HYW 99
VANIC:UUV4 ti` WA 98665
Phone if': Y .1 16. 46 TWAL
80169
RLUU I RL-:U 1 Nzal-'f_( 1'1 ONa
This permit is issued subject to the regulations contained in the F r-Am i l7 g 1 nsp
Tigard Municipal Code, atate of Ore, SFecialty Codes and ail other Rain dr^a i n I n sp
applicable laws. All work will be dorc to ac:ordanr.e with Final Inspect ion
approved plans. This permit will expire if worm is not started _
within 190 days of issuance, or if work is suspended for more
than 190 days.
er,mi t;tee Signature
zel
LaII for• insplection — 639•-4170
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a«
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
/ �23y6,
Jobsite Address: � �. 6- e,/,' % �'.�� z--
Subdivision:
'Subdivision:/��+ �� Lot# — Office Use Only y
Planck/Rec
Valuation: T-500
Corner Lot? Y N Permit # } r 'mac"1 U l 0
Flag Lot? Y N Reissue of ■
Map & TL# 17.5 10 C </U 0
Owner: /f ,� hn/`l/ / _ Approvals Required
Address: / /�/�( C /` C''�i u
Planning
Engineering
Phone: C'ther
Contractor: A(CAS(t(G, (•rT i /i r�
— �` � � Items Required
Address: C ' Y �11 Subcontractors
G Truss Details
Phone: %tea/ &I,
Othpr _
Contractor's License # Cr' _
(attach copy of current Oregon license)
Contact Name & Phone: i4l —_
Subcontractors: Arch itect!Engineer:
Plumbing: Address.
Mechanical:
(attach copy of current OR Contractor's License)
Phone:
I
JOB DESCRIPTION:
Applicant Signature & Pnone number
Received b
��� 1 Date Received:
N MORMCOMMARF.SAPFI
Permit# Account Dea(:ription Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUM-1)
_ Mech. Permit (MECH) _
State Tax (TAX) 3 q .3
Bldg: �( t
Plumb:
■
Mech:
Plan Cf,,ck (PLANCK) _ ' , `� e
Plumb:
Mech:
I
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC') -
- I
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) _
I,
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-0)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE) _
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
I
TOTALS:
4
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i
ry
KING CITY
tri 15300 S.W.110th Avenue,King City,Oregon 97224 Phone:N39.4082
,i
BLJ I LD I NCS PERM I T ADPL, I CAT I ON
DATE-_ KING CITY BUSINESS LICENSE N0.
NAME 0 AP LICANT_L(LO"dI'�(,'�IT -//(!/J/> PHONE NO{' 06Z1- ���'r L
AiIDRESS
NAME AND ADDRESS OF PROPOSED IMPROVEMENT_-I�?tL-_.,MP. -s.A/�-_
�' 1�1 �-�_4_00e 6/? PHONE NO. k;
NAME OFCONTRACTOR.-&-6✓---e�
/ / /<: lt.11 C�� SE NO.
ArnRESS��)r_ ..C! �_ � _—
TYPE OF CHANGE OR IMPROVEMENT FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH A COPY OF THE PLAN OR DRAWING OF PROPOSED
PROJECT-
SIGNATURE OF APPLICAN'P__
*APPROVED APPLIC _ONS ARE VALID FOR SIX. MONTHS ONLY*
NOTE: Oregon Hompbui lders [,aw requires that all. persons who contract for work on
n residence be registered with the Builders Board which means the
ccntr.actor is bonded and insured on the job site. For your protection, be
certain your contractor is registered by calling the Construction
Contractors Board at 1-503-378-4621 Extension 5000.
FOR OFFICE USE ONLY
APPLICATION RECEIVED BY-__ �- _ DATE_ /19- So 17
U U
APPLICABLE FEE RECEIVED $ COIDITION^P/COMMENTS _
J �P c -6 C1 cL Y-A -Lvl
APPROVED BYDATE
7 �L fes ` a
Note: A nerm.i t must: . so be abtaifrom the City of Tigard Department of
Community DeN•elopment Yes No-_
*********�rrlryltiittt91trk1k'.rltrlt'ktk:ltok�lt*yltrk�k*tt7k*itrlt**rlrrk�ltrlc�k*ylt�krk�k�ltrt7k�lt�ltrlrak*tk***�k'*i'�It�k*
CITY-OF TIGAARD INSPECTION REPORT
This project has been inspected and: Approved Denied—
Comments
Signature _ Date
(Building inspector please return one copy to King City)
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:I T Y (IF' 'I"T GF=ART) RFCF 1 FST CIF PAYMF'NT' RE'CU T F'T NO. a 95- -62574 `
CHECK AMOUNT a '71. 43
NAME a NORTHWEST F-T N r' l l C.AGII AMOUNT : (a. 00
ADDRESS .r27 NF HIGHWAY 119 PAYMENT DATE: s 4'►;c Ct? '�"
VANCOUVER, t4A L111l01 V I'S10N a
9H6F.5--
PL.IF'.POSEF OF PAYMENT AMOUNT FIA 11) PIIRPCS ' OF PAYMENT 0MCILINT PAID �
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,P386 rW Klhil,'3 GEE]F GA'. L)R
AMC1UNT Ff'71:1
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CITY CIF 71GARD RE:'i:'UIV'T CII" F,AYNiE:NI NO. a95-26101.r
rHEZW AMOIJNT ! 44. 53
rdw�ME=. PAIt•:1G, TFE) �t�H AMOUNT a 0. 00,
f►E)D R Fr aS a 1 ,13Hf, KINS GF.:nRGr F'AYMCrJT UATF:: a 01/26/95
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F;I NG C t TY, QFtI='OON 972 4-- f
iOUF�i rit;E C1F F°AYMf_N"r IlMCII.IN"1" F?AI1) CII.IFIF''IIC;E�: OF F'IaVME'NT rIMCri.JN'r r'Nli�
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PLAN CFEVX FBBS LIST j
PT" CHEM R /-�.' i PERMIT # DATE;S TRX/taP/rA)T
SUBDIYISICSI /i l LOT LARD
1LZC1fit 7 S �' V RERR LEFT RIGHT
T. C3ass c< wxGur!ZZ 1�PAL AREA
USS T'!PB S F Fid LOAD ' 2.ST
DIST TTPB S WMT TTPS2ItD
3RD
QOCDP/LGAD # DXCD ROOl1',^sBA.SEMI I
I ._..._L_ # BATHS GaRAGE -
PZRMIT # TIOU AWtm- ANDWT PD DAL nog
BUILD PMT FEES f(S
PIS PETIT
MEM PERNIT P7E.S
STAU BUILD- TAX(St) 3
BQILDIIIGV z
PLUMBIRG
NEXUTANIC AL,
PLAN CHECK FSB,^ Ll y 3 c f U�.� -3
BUI J)lm
f W®C�ffiICAL i
SEmm C70I(TIOK
S MM IP.SP®CI'IOK
SST SYSTEM
S'TORN DRAIJUM SYS _
PARKS SYSTEM DRY
i
EROSION PERMIT
ER4SIO�T PIAN USA
ERSO100 PLAIT CDT
TOTAL,