12720 SW KATHERINE STREET-1 MIN
'2720 SW KATHERINE KREET
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INSPECTION NOTICE
City of Tigard Building Departmen,
2420 S.W. Main St.
Tigard,0,,,,, 111123
Phone: 639-4171
Type rf 1.1%pection -------
Date Requested lop, -Time
A.M. P.M.
Address Permit
Owner Lot
Builder
Thi fullowing Building Code deficiencies are required to be corrected:
Presetited to
Approved
It spector Ll Disapproved
Date
Z12 :;sz
CALI, FOR REINSPECTION
El YES 1-1 NO
INSPECTION NOTICE
City of Tigard Building Department J
12420 S.W. Main St.
• i igard,Oregon 97223
Phone: 639.4171
Type of Inspection -
Date Requested Time 115, _P.M.
Aadress
Permit
Owner_ r/'&Y1
Lot #
Builder
The following Building Code deficiencies are required to be corrected:
_ - "• ti .� 1L f `..,.� �tea.....
Presented to Approved —-
Inspector
----- ?_� ❑ Disapproved
Date 2
CALL FOR REINSPECTION
Cl YES ,4� NO
INSPECTION NOTICE'
City of Tigard Building Department
12420 S.W. Moir St.
Tigard,Iregon 97223
Phone: 639-4171
'type of Inspection P ---
Data Requested
R M—e A. M.
PA .
Address -3
' 7
f—, Permit
Owner
Lot #
Builder
—
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector'
Disapproved
Date
CALL FOR REINSPECTIOAr
I
F1 YES ;7 NO
(�
BUILDING PERMIT APPLICATION TIGARD DA1F '' 53f�3
THE UNDERSIGNED HFREBY APPLIES FOR A PERMIT FOR THE 1^JORIt HEREIN INDICAI ED BUILDER PHONE 64-0-4769
OR AS SHOWN AND APPROVED IN I HE ACCOMPANYING PLAN'' AND SPECIF'ICA(IONS, OWNER PHONE
LOT NO.__--jl,',
OWNER Jefft,:arrQn JOB ADDRESS I2J�+.• 5W ECxtlldl�3.irG Sta
Sherwood ARCHITECT
ENG114EER
BUILDER .Jacobs Construction ADDRESS Rt. '4 Box 394 J DESIGNER
STRUCTURE _ ❑ NEW 1-1 REMODEL R ADDITION ❑_REPAIR _U RENEWAL ❑ FIRE DAMAUE ❑ DEMULITION
112 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO L] CARPORT ❑ GARAGE ❑ STORAGE
17 SLABEI FENCE
OCCUPANCY �1t�•3 _LAND USE ZONE *+t1._BLDG.TYPE FIRr ZONE-- ----PLAN CHECK BY
HEAT--.-.
Constrisct Mid Story addition to oxil,sti"', mingle fancily dwelling.
SEWER PERMI'l-
OCC.LOAD _ FLOOR LOAD 4U HEIGHT NO. DRIES I — AREA _686 NO,BEDROOMS VALUE
_
BUII DING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE _
Parml; 92+S(? THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 6rJ.j'; REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
—_ WORK WILL BE DONE IN ACCORDANCE: WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCEWITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOTWAIVE
Sub-total 157.63 _r RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
3.70 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total 156.33 SDC—
���—- -
BY C:L PDG# APPLICANT OR AGENT
_
Receipt N�,
Approved 1�Gfi A p - - PNnNF •—
,� Iy/
DATE INSP. TY DE INSPECTION REMARKS PLUMBING DATE
COnTiaclOf
MIPermit N
A:
Rough-In
4A
,allx
Fin' r
H
G
Con tractor
Permit Ivu,
C�,
--A4L�.ft
Gas n,Oil
Rutigh in
Final
9rWER
Final
DRIVEWAY
Final
Storm Drainage
Min Drain)Final
Sidownlk-----
Curb&Street Final
Ap-roach.
8L00.0 WA -iEiWP6WARY El4TIFICAT LIP NCY
CE?TTUL:
IFICATE OCCUPANCY C4 Landscaping
Zonion Final
I
'3 i
-- 14
BUILDING PERMIT APPLICATION TIGARD DATE__--
1
THF.UNDERS'GNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
DR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. LOT NR PHONE
&VULWAd—ff
JOB ADDRESS t7
—�-- �yut'041 6 ARCHITECT
ENGINEER
7 DESIGNER
BUILDER c � ��/ice i1�AQRES� —
STRUCTURE ❑_NEW ❑`REMOOEI. 0 ADDITION ❑ REPAIR O RENEWAL O FIRE DAMAGE E] OE�AOLI1
RESIDENCE ❑ COMM ❑ EptIC/ITIONAI ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT CZ GARAGE G STORAGE 0 SLA80 FEI
�!
FIRE ZONE PLAN CHECK BY HEAT•--------
_
OCCUPANCY __LAND USE ZONE ` ' BLOC.TYPE ,— _ — ----
SEWER PERMIT It ""7'
NOBEDR
OCC.LOAD FLC"JR LOAD
HEIGHT NO.STORIES
AREAS_ . MS � VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SInE RIGHT SIDE
Pormlt L THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS GULAONS CONTAINED IN THE BUILDING CODE.ZOd
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED TEAT
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPU4
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W
Sub-lolal -- LRESTRICTIVS COVENANTS.ICENSE.SEPARATE PERMITS REOI CONTRACTOR URR£!tT CITY BUSIN
RED FOR SEWER,PLUfAqltAG AND HEATING.
SIaU Tax
SDG—
Total APPIJCANT OR AGENT —,--
By -----
lecolpt No. AOORES5 f NONE
App"e4
SOC
SEWER CONNECTION 8 -
SEWER INSPECTION $ -
SEWER SURCHARGE 5
�,_--
BUILDING RECEIPT
NAME: r n ` _ DATE: _
ACCT DESCRIPTION AMOUNT
10-432 Buildyng Permit Fees
10--431-600 Plumbing Permit Fees
10--431-601 Mechanical Permit Fees
10-230--501 State Building Tax S 13, '��''
10-431 Plars Check Fee $
30-443 Sewer Conncction (20X) $
30-202 Sewer Connection (AD%) $
30--444 Sewer Inspection S
51-448 Street System De%#. Charge (S')C)
52-449-610 Parks I System Dc-,v. Charge (PDC) $ _
52-449-620 Parks .iI Systlsm Dew. Charge (PDC) $
31--450 Starm Ori inage Systcm Dew. Chrg (SSOC) $
10-230-505 TRFO (95X) $ -
10---478 TRFD (5%) $
10-230-506 Washington County Fire N1 (95X) S
lu --478 Washington County Fire 01 (5%) $
10-220 Amart/Wedgewood S —
TOTAL Sz `'LL
(bs/1214P)
Y'
BUILDING DEPARTMENT, TIGARD N? 2898
PLUMBING PERMIT
<, _ holder of a valid plumbing contractors license is hereby
authorized t cause plumbing work as ,�ein noted to be installed in ar.ordance with the plumbing code of
Tigard. Such installations requiress than four
e ins con by reed City or Inspector who
hCity of Tigard Beusinessnnt l License required
(4j hours prior to the time the installations are y
actors and sub-contractors. fob _
for all contractors _
h�zr Y. AddreS81 s ) ;�.l r 'i.t' �i ;.. gate
Owner a - �'
NUMBER OF TOTAL
AE F�5 IT ITEMS FEF. ON EACH AMOUNT
2 .00
Si Is Famll -1 beth-each -
/25. --
Duplex-Each 1 beth unit _ - 10
additional bethr0oms-each
Mobile Home Specs-each _
INDIVIDUAL FIX_TUREB .COmMERCIA -
_ _
I to 50 Fixtures in 1 building
_ 51 to 100 Fixtures in 1 building_each
101 to 200 Fixtures in 1 bW1(r1R --each , 1,50
201 or more Fixtures in i builder-each
MISCELLANEOUS -
- -� - 10.00 - —
5ewer_ eoch edditlonal ICU its, -- 5.00 - —
Water Sorvice to building - -- - �—
.
Other S ecir
L
PERMIT_ ��L�� For Plurnhing inspection Phone 639-1171
State Plurnhing Contractor By
RECEIPT VO. Issued By
TOTAL - ^�
w w tt■i w w
BUILDING DEPARTMENT, TIGARD
PLUMBING r EFih11'I ��
_ QCXnM*' A n—A-1-r,44 Cn _ ___, holder of a valid plumbing contractors license is hereby
authorized to cause plumbing as herein noted to be installed in accordance with the plumbing rode of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. Job
Owner_.µ. , "aim _ Address 20-In ZAU Datc�L0
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS BEI: ON FAC" AMOUNT I
_n111pLV
_Sin la Family-1 bath—each _ 25,00
Duplex—Ench 1 bath unit 2_5.00
Additional bathrooms--each —�_ — 10.00
Mobile Nome Space—each r 15,00
INDIVIDUAL FIXTURES C[l(�f�lEf�CiFll
_ .
1 to 50 Fixtures In 1 buildino—each 3.00
51 to 100 Fixtures In 1 building—each
101 to 200 Fixtures in 1 bu11di2 —each _ _ 2.00
201 or more Fixtures In 1 building—each 1.50
MISCELLANEOUS
Sevier—each additional 100 ft, _ 10.00_
Water Service to building 5.00
Other S eeif 1 23
PERMIT / ,0,0 C7 for Plumbing Inspection Phone 639-4171 +
A o tate //0 Plumbing Contractor Py �1 '
I Q7Al. /C�,
.__. �C RECEIPT NO. ISM, l tiv
I
of i_ilgcrd
a j ZZPECTI ON REQUEST
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---_ 'SIT
DATE: A''- 0.47E ,SS::£D
CW,NFr:S NAME :�f
ati;i:RESS: /,,tT-k-PC
CON"RACTOR
TEST : Ai-
Li
IRESULT: Apl�,-,-vqd Pen di-
S KzT�N;
INC, C"r0R DATE
test dot(.
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City of Tigard
INSPECTION REQUEST
t r,
for
IINSPECTION TIME : �� � s �'`�" PERMIT NO.' —
DATE: .�/--'�� '� DATE ISSUED:--j
OWNERS NAME : —IskG4c - CZ r c Zn
ADDRESS : �:�. Fs '_.�' ►
DONTRACTOR :
TEST: Air u, Nater [i , visual _aboratory
RESULT. Appr^vad, , :)'.a:ipproved ' Penjing
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1 1 SPE CTO DATE
ICNOTE: Attach evpplemental toe' data here'1
„ x wu ,. ro ,..,o�,wa.,.,..n....r1t.a.,,,.w,,„,rw,.,� w,wo...,1�►r,.pl�x,.+a�v+�s.w,p• .: .,•o.,,,�
CITY 0'
7
N2 0353BUILDING PERMIT APPLICATION TIGARDDATE — t9
THE
�
UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN 1 HE ACCOMPANYING PLANS AND SPECIFICAT,ONS. OWNER PHONE —
owNER .1OADDRESS LU* 1272'0 3,,w. jt IM t ” rttxl
ADDRESS AUILDER PHONE _
ENGINEER
BUILDER —__ _�— ARCHIT€CT DESIGNER
STRUCTURE ANEW ❑REMODEL — ❑ADDITION OREPAIR ❑RENEWAAL ❑FI��^^JR--��EDAMAGE ❑_DEMOLI'T';)N
u RESIDENCE: ❑COMM ❑EDUCATIONAL ❑ ❑
GOV'T RELIGIOUSQPATIO OCAR PORT 0GARAGE LSTORAGE EISLAB FENCE
❑BOND CI MOVING
—]CONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED L1sIGr•s '
.S�CCUPANCY LAND USE ZONE L3-.--,—BLDG.TYFE FIfiE ZONE PLAN CHECK BY HEAT " d,
construct; 1240 aq. ft. 1-a story dw all.ing With attached garage 40,111
--- 1,gee+w nt - according t,) a .1praVed planta ---
w� bedroues
2CC—LO O f _FLOOR LOAD 40 lb _HEIGHT �NO,STORIES 11._ AREA _ VALUE
DEP
BUILDINGARTMENr 79
_._ _. —. SET BACKS FRONT REAR LEFT SIDE RIGHTSIDE
Permit 133.(j0
—` THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cneck 1 1050 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
` WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANE,SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITU BUSINESS
1%State 1.33 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
Byr III, '1
-- --"- APPL.IC.ANT 017 AGE.tJI
Approved Receipt No. --- "
ADDRESS PHONE
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DAME INSP. TYPE INSPECTION REMARKS PLUMBING DATE
L1",i'�� !-�•- -t L. Contract
Permit No.
L�I'��'�<=t�•�f�� �? --72d Rough-in -
_ Cad Q- �C �Q� <�'t' - �,z.�4 Fixture
Final
HEATING
Contractor
3 S 7 Y y
Permit No. —
G
7, Gas_ Gas or nil TO&*L/i3 _
Rou h•i n _
— Final
SEWER OK. QL-1
Final
DRIVEWAY/n-i(o•7-
Final
Storm Drainage
(Rain Drain) Final
Sidewalk /0,1b•7 S
_ Curb&Street Final
A roach 10-1 b
L -
BLDG.DEPT, FINAL — TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY — —
Landscaping
Zoning Final
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Al"ORESS 2- 7;z, 26-) .11 r NO.
PERMIT CHARGE none
OUNER �W____ COHNEITION FEE lfz sl—
PAID BY
OF ouii-oitir.
DATE C 0 14 N'�c T F 0
St-11VICE RATEFEE
CONTRACTOR PAJO BY 0.11-E611 4—
SIZE OF COINNF.CrION A!33FSSMENT PAID
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