15298 SW KENTON DRIVE 15298 SW KENTON DRIVE
� ^ CERTIFIC'A'.: OF'
CITYOFTIFARPmiOCCUPANCY
CITY OF TI6AItD
taE.RMIT 0. . . . . . . c MSPT'30--026E)
COMMUNrri DEVELOPMENT DEP.JAtAT4�I T eReoer'e
13125 SW FWI Blvd. P.O Box 23397,TiWM,Oregon 97223(603)133941!75 DATE I SSUF 9 e 12/28/90
i I TE ADDRESS. . . 1 15ti1 SW KEN VON UP PARCEL- �'ra 1 12C 8—')wf300
SURD I V I t;I ON. . . . 1 pr;1 UH1',5 Z ON I NC e
BL.00K. . . . . . . . . . r LOT. . . . . . . . . . . . r 112
CLASS OF WORK. r NEW
T'(PE OF USE:. . . a SF
OCCUPANCY GRP. eR3
OCC;UPANf.,Y LOAD a 220 4
14"NAN'T NAME. . .
Re mArks
1(.e MILLER
Ulf BOX L3291
T I OAPI) OR 97223
Phone #t 684-7543
Contractors —_.---------------..----..--__--
.JAY MILLER
F117 E'OX 023291
T I t;"IRD OR 97223
Phone Nr 68, _7543
Reg #. . t 30, 59
Occupancy of the above referenced but Wing i e her,Pby y i ven, and cert i f i c
the compliance with the State Of Oregon Specialty t od"ti for the 91-0o1n,
occ!.Ipancy. .na use Linder which the referenced permit was issued..
X-OW _(1)�
FIRE DEPARTMENT UIL_DING INSPECTOR
IJILDING OFFICIA1,
POST IN CON '')I CUOUS PLACE
MJJ'W est r.s .a M MR .t we esr
1
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone, 639-4175 11
Type of Inspection
Date Requested_ �a J Time_ A.M._._ P.M.
Address /�� p e;..'; 7
-�-- 9' `S G�.� ���`�IT�„_1 Permit #_�1G�
Owner _-__-- /. Lot #
BuilderThe following following Building Code deficiencies are required to be corrected:
-
-
Presented to - - -__._.-- Approved
Inspector — _- -_ Disapproved
Date
CALL FOR REINSPECTION
El YES C) NO
Mm t� sew ssr w ses + snr w
IN¢_PEG'IION NOT:LC4 {1
City of Tigard Building Departsient-
13125 SW Hsl Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-P`gona)s 639-4175 Business Phone: 639-4.171
Inspections---- i a -----_._----
Footing Plb Underslab Mech. Hough-in 11ppr/8dglk
Found. Plbg. Top Out Cas Line rlKRLs
Poet/Ream Struct. San. Sewer Framing -Bldg.
Poet/Ream Hoch. Rain Drain Inei:lation -Piumb.
PIbg. Underfloor Water Line nyp. Bd. -Mach.
Requested:- _� Z_f��_-----�-Time: AM PH
Mo._f:eaes I �`-Y k Permit
Builders
THM FOLtA3WINQ CORRECTION(: ARE REQUIRED:
Loa C---
7
Inspectors / // ,��'%�1� ___ bate:�4 � O
J_—APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
t
i
�\
Ir 1 i City or Tigard Building Department rJ 1
L- 13125 SW Hall Blvd. Tigard, Oregon 97223 ` l�
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
looting Plbg. Undorelab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Tamp Out Can Line FINALS
Post/Beam Struct. flan. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain InsulationI- !Plumb.
Plbq. Underfloor Water Line Gyp. Bd.. -Mac_y>
Date Requested: Time:
_ _��AM PM
Addreses���Le �1C1�.�- Permit is
TfsE FpAAMING CORRECTIONS ARE REQUIRED:
Ae s /c'S /�I'i �' r OXY �/�
7nnrecto Dates
" ✓ ��
rZ —APPROVED DISAPPROVED APPROVED BUBJECT TO ABOVE
Call For Reinsp.
City of Tigard R+rilding Depart-Ment V
13125 SN ball Blvd. Tigard, Oregon 97223
Inapection Line (Rec-4-Phane): 639-4175 Business Phone: 639-4171
lnspecti .�-- — ----- --- —._.
' Footing Plbq. Underelab Mach. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Ream Struct. San. Sewer Framing -Bldg.
Post,/Beam Mach. Rain Drain Insulation
F'lbg. Underfloor Water Line Gyp. Bd. -Hoch.
�yJ-�/ � Timet __�L_AM PK
Date Requeateds
Address: fy„ -�c1� l�E 7 A-G' -c J Permit is �� G
� y
Builder:_ GGL�GLL_�
TIIE FOL A)WIIN'GG OORAECPIONS ARE REQUIRED:
Inspector: Date:_
APPROVED DI.4APPP.OVRD -� APPROVED SUBJECT TO ABOVE
call For Relnsp.
INCPBCTION NOTICE
City of Tigard Building Department ���
13125 Sri Hail Blvd. Ti.gar,l, ore'.Jon 97223
YV
Inspection Line (pec-&-Phoney: 639-4175 Business Phones 639-4171
Inspections _.._ - _
Tooting Plbg. Unders)ab h. Rough-in Appr/Sdwlk
Found. llbg. Top Out Gases FINAL:
Post/Ream Struct. San. Sewer lr=Lng -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor water Line Gyp. Bd. -Meth.
l�—� -f7 G� �- PM
Date Requeet:edt --Time: AM
Adclroset �� ' — - Permit
qu i.tder t
THR FOLLOWING CORRECTIONS ARE REQUIRED:
L eM
innrector `,_ _ Date:
G� ATPPGVSD DISAPPAOVRD APPROVED SU&7ECT TO ABOV2
Cs11 For Reinap.
INSPBCT?QN NO: CB
City of Tigani Building Departaeat
13125 SU Hall B1•.d. Tigard, Oregon 97223
Ineneati.on Line (Rec-O-Phone): 539-4175 Business n s J9-4171
Inspections
Footing Pl.bg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. rop Out Bae Line FINALS
Post!B�sam Struc::. San. Sewer Framing -Bldg.
Poet/Roam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Nater Line C pyp. 8d. -Mach.
tate Requested: i�G/// ftmet __2L_AM PM
Address: 9 .n�� ftroLt #i
� rY
Builder:__
q
THE FOLLOWING OORRECTIONB ARE REQUIREDi
i
1
Inspector:_— — [o
-1�- 7) U
i; ._APPROVRD DISAPPROVED APPROVED SUBJECT TO ABOVt;
Call For Reinsp. Alk
t
r�
�7S.PECc�ON_1�-�E
City of Tigard Building Department
13125 Bid Hall Blvd_ Tigard, Pregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion: _--- ----- -
Footing Plbg. Underelab Mech. Rough-in Aplar/Sdwll
Found. Plbg. Top Out Gas Line FINAL:
Pont/Beam Struct. San. Sewer Framing -Klug.
Poet/Beam Bach. Rain Drptn In ulation -Plumb.
Plbg. Underfloor Na/ter Line Gyk.. Bd. -Nech.
Date RequenY.ed:lqq �1�iP�_- __ ______Time: SAM ----PM
51 i` O-_ �7 ��' Permit
Addresns
Builders- -7`� � -- - - --
THE FOLLOWING CORRECTIONS ART REQUIRED:
Inspectors --// A 1 Date zz JGr�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
aar a� q. rata � a. «an as aMlr
.*HCTION NOTICE
City of Tigard building Departs nt
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing T Plbg. Underalab Mech. Rough-in Appr/Sdwllc
Found. Plbg. Top Out res Line FINAL:
Poet/Beam Struct. San. Sewer Frening -Bldg.
Poet/Beam Mech. Rain Drain neula`i— i Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested:_ f���_�j�) .__Time' _ _AM - / `PM
Addr_eea:___ Permit �:_��,,��_�.�ti'dc .
Hui.Ider:
THE FOLLOWING CORRBCTIONS ARE REQUIRED:
Inspector:__ �/`► -- ._..._ Datat
--�—APP'JOVRD _ DISAPPROVED -_ APPROVF,D SUBJtCT In ABOVE
For Reinsp.
I
�aspacTlog_ncrric_r:
City of Tigard Building DepartAJ6"t
13125 SN Rall Blvd. Tigard, orrogon 97223
Inspection Line (Rec-O-Phcne): 639-4175 Business Phone: 639--4171
Inspections - I—
Footing Plbq. Underalab Hoch. Rough-in Appr/Sdwl'A
Found. (Plbq Top OuY/ Gas Line FINALS
Moet/Beam Struct. San. Sower Framing -Bldg.
post/Beam Koch. Rain Drain Insulation -Plumb.
.,lbg. Underfloor water Line Gyp. bd• -Hoch.
Date Requested:— PH
Address.- � e� �. 5'r� �iYT•.^ .'ermi-t
Builder:--
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors��, _
APPROVari DISAPPROLBD APPROVED SUBJRCT TO AR NE
Call For Reinsp.
City of Tigard Buil J Departatent ' f�
13125 SN Ball Blvd. Tigard, Oregon 97723 lf�/
Inspection Line (Rec-•o-Phone): 639-4175 Buainnpa Phone4_
Inspection: ---
tooting Pltg. Underrlat Mach. Roui;h-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line tINA.T.:
Poet/Beam Strutt.. San. Sewerreq -Bldg.
G_
Post/Bean Mach. Rain Drain Insulation --Plumb.
Plbq. Underfloor Nater Line ^ Gyp. ad. -Meeh.
Date Requesteds �t✓ y�� TiAles 7`� AM - PN
Addreas:� �� �4Fd Z Ct!51� Peralit S:
Builder:
THE FOLIA-MING OORRECTIONS ARB REQUIREDs
To
Ctic'c uiv -�i T �i`-S1/ c
Q kT R -9 7-c 13Ap k rM
w / � 4L /v
9'f ,q 7- , v
Inspector:_-- -� Date:4)Z�v
APPROVED DISAPPROVED APPRCNRD SUWNCT TO AHOY=
Call Por Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 r
Tigard, Oregon 97223
Phone 639-4175
Type of I nspectio►i Az z, �,�e- . L -c i
�j�' a
Date Requested TI r In A.M. P.M.
Address r_;� �'1 � iti� Permit
Owner _ Lo' #
Builder_ 222.1 _--
The following Building Corre deficiencies are req.tired to H corrected:
-
Pr---..,(ed to _—__ � Approved
Inspector Disapproved
Date
CALL FOR RFINSPF,CTION
L..7 YES ❑ NO
INSPECTION NOTICE 3, /
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested _. "�^ Time�; A.M. --_ P.M. -
Address � / Permit
Owner Lot #
Builder _-?��-�f.�. _
The following Building Code deficiencies are required to be corrected:
- --�" - _
i
Presented to SCI Approved
Inspector `e� '!'� /// "`
Disapproved
Date
("ALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone,639-4175
Type of Inspection
Date Requested_ /� � '� � Time 1.M:'�M.
-1
Address1 __ Permit
Owner _ Lot
Builder_—4�--&-/ 1 _--
The following Building Code deficiencies are required to be corrected:
Presented to
------ ---- —._ L�pproved
Inspector �'" I 1 Disapproved
---- pproved
Date
CALL POR REINSPECTION
rl YES Cr1 NO
s w w w w w
INSPECTION NOTICE
Gity of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested — -_ 9d Time_ A.M. P.M.
Address � _ i��—_ —� Permit #�—,—
Owner _ _ Lot #-----�---
Builder
The following Buil ing Code deficiencies are required to be corrected:
Presented to ___. [ Approved
Inspector __ __ _ ❑ Disapproved
Date k
CALL POR RkASPECTION
❑ YES lA NO
_ INSPECTION NOTICE
' City of Tigard Building Department
P.O. Box 23397
l 3� Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _ �_ ;6� ;
�. l ! '
Date Requested--i �Tim� .M.--- P.M.
Address _�`S ,�`�/,�' .��s Permit #�'__._._L
OwnerLot #-_
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _....... Approved
Inspector —__ ( Disapproved
Date
9h
CALL FOR REINSPECTION
C i YES 1J NO
CITYOFT167ARDIIIA:STLR CrTyOFTWA7
COMMUNITY DEVELOPMENT DEPARTMENT 0"Q*N a. . . . . . . : MS 190 0 2(-:,8
13125 SW Hall Blvd. P.O.Boot 23397,TOW,Oregon 97223(603)639-4175 PR I M. PE R M I T 0. -. 11 G'r 9 0 0268
6i;9 4i-4 f,99HE.On
ODDRE 15298 SW KENTON Df%' PARCEL. 2S1121,B-09800
fiLJPDIVISION— . — ASI-If"ORD UAKS ZONING:
1.4 1.-0 CK. . . . . . . . . . ..
BUILDING
Rf;:ISSUEA DWELLING UNITSil BASEMENT. . . . . . . . CO Sf
(.11--I:1SS OF WORI,',. -.IIEW BEDRMS 1,3 F,AT i-i s.3 GARO GE. . . . . . . . . . ..420 S f
l'Yl:.,E OF." USE. . . i SP FLOOR REUUIRED SETBACKS-------------
'T'Yl'-"E OF CONST. -.5N F:*IRST. :970 S f LEFT. . .5) ft RIGHT. :5 ft
()C C U PA N C Y GRP. I R3 SECOND. . . :864 5f F:'RONI*. -20 ft REAR. 28 ft
G T(')RIES. . . . . . . ..2 TH IRD. . . . -0 S f R E QU I R ED––––
1 .7 . - 834 Sf SMOKE DETECTORS. :Y
II:.J GHT. . :20 f t T 0 TA L. . 1
V-L 0(.')R L.0 A 1). . . . n40 psf VALUE. . . . . (14;'88 PORK ING SPACE'(3. 0
PLUMBING
1'.N K 13.. . . . . . . . . . . I FLOOR DRAINS. . . . :0 BACKFLOW PREVNTR5. . 0
i AVATORIES. . . . . ..4 WATER HEATERS. . . '. I TRAPS. . . . . . . . . . . . . . :H
I'D 1.4/9 H 0 W E R S. . . . ..3 LAUNDRY TRAYS. . . : 1.� 1 CATCH BASINS. . . .. . ., . :0
WATER CLOSETS. . 9 3 SEWER L.TNE (ft) . .0 GREASE TRAPS. . » . . . . .0
D T GHWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER FIXTURES. . . . ,. :0
GORBAGE DISP. - . N I RAIN DRAIN (ft) . 0
W051ATNG MACIA-7 - 31. 13r-: RAIN DRAINS. .. : :I.
MECHANICAL FLES ............. ---
I UNIT HTRS. . -0 type a ni c)t.t ri t 1i ly date -re pt;
G 03 VENTS . . . . . ..0 PAYM $ 100. 00 JLH 08/02/90 20,33.14
HOX INPUT".0 BTU VENT' FA NIS. . -.3 SPIRT $ 138(3. 00
, 1)1-�N ( 1OOK HOODS. . . . . . :I HPLC $ 252. 20
I URN ):--:I.00K . . .-0 WOODSTOVES. v B-Ijf)c $ 19. 40
( I (JOR FURN. . . . :0 CLO DRYERS. : 1 STDs s 600. 00
):'0 1 L./C'M P 11 P L-0 OTHER (JNI*rs.*(d SSDC $ :3.75. 00
GAS OUTLETSsl PARK $ 2501100
1)W 1-1 e-r MPRT 1, 36.00
10Y MILLER MPLC $ 9.00
I,() BOX 23291 115PC $ 1. 80
PPRT $ 1551100
I I(:1ORD OR 97223 1-'51:11" $ 7. 75
1 Iic)i-ie #-. 684--*7543 PAYM $ 1.994. 15 HCR 08/06/90
I)traeto-ri
iii)' MILLER
i,o 1.'30X 2,3291.
1 IiARD OR 9*7223
1,I)orie 41 684-7543
#. . t 301.09
c'.094. 1.5 TOTAL
This permit is issued subject to the regulations contained in the RE OUIRED INSPECTIONS
Tigard Municipal Code, Stil-e of Ore. Specialty Codes and al! other F00t/fOUnd Insp Meefiati-ticAl lr),sp
Applicable laws. All work will be done in accordance with approved Wt-r P-roafing F'sm r1l.t.trnb 'TOP FJLtt
plans. This permit will expire if work is not started within 188 Post/Beam St-fto.et F-ratniriq Insp.
days of issuance, or if work is suspended for more than 160 days. Plt)st/Beam Meetiari Fireplace Iri-,p
Crawl I)-rAi.ri Gas LJ.iie
PLM/Unde-rf loo-r Gyp Boa-rd Ivisp
I !it I e d By z Drair) f.'Isnilt RAi)i (1-(,Ai -Ir
It 'P
Lal fa-P ----–------------
OMNE TI ON
E'W E'R C
CITY OF TIVA RD CffY0FTWRD V,11 R 111 T 3
COMMUNITY DEVELOPMENT DEPARTMENT MOON #. . . . . . . .. SWR90--0': V)
13125 SW jjWj Blvd. P.O.Box 23397,Tigiud,Oregon 97223(503)639-4175 R 1.N. V,1:..R lyl 11' 0
01 1 L. ADDRESS. 15298 SW KE-'A F011 DR ZI-)NING:
7 7RID
1*:i1.JBI)J'V* SION. . . . I ASHFORD OAKS
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . .. . ..
............
11"N A N T 11 A ITI C.'
U150 NO. 42350 FIXTURE UNITS. . .
DWE.L.LING UNITS-0.
CLOSS OF WORK. . . '-NEW NO. OF BUILDINGS.1
TYPE OF USE:.. . . . . ..SF
INSTALL TYI**'E. . . . cBUSWR 111VAERV SURFACE. .
Renii-rks:
Owvle-rg FEES
'JOY MILLER type AnioLtvit I)y flAte reel:0.
i::,o BOX 23291 V,R M T 1500. 00
I N S P 1, 35.00
VIGARD OR 97223 P,0 Y M 1; 1.535-00 BCR 08/06/90
684-7543
GONTROCTGR NOT ON FILL
#x 1.5351.00 TOTAL
REOUIRED INSVIECTIONS ..........
Disr)eeti-011
This Applicant agrees to omplywithalith rules and r ulations Sewe-r
permit
e
1
p )i o
of the Unified sewage Agen The. permit e fres 12 .ys,from .......
ttie date issued. The total (Ount paid will be fo-feited if the ..........
- b
'0
permit expires. The Agency M4 not quar ep the &CCUTAC.Y Of the
not located
side sewer laterals. If the sewer not located at the reasurement ................... ..........
given, the installer shall prospect 3 feet in all directions from ............
the distance given. if not so located, the installer shall purchase ----••-•-•-•••--••-•-•
a "Tap and Side Sewer" Permit and the Ale cy will instal� a lateral. ......
I-IA t,t,t rex ...........
e r n) t t e
....................---
SS U e(I T*j .................................... ..........
fc).(, .1.1.1tipectiaii 639-4:175
,,,, T'Y' OF TMARD FRUTElr-"T OF PAYMENT RE(A--'TPT MJ,
AMOUNT
NAME MILLEP? BLEIR. INC. CASH AMOUNT
f:-Ay'MENT Vi*-iTt' i
A D D R E G5 BOY 27,2.9 1 1
I-I G�ApD, OP 9-7
j3IFAmijUt4T F-AID
Atio'.JNT PAID PAMENT
7o FTFjiM-r-�iTr E i-�1'1-1- _w__,_ 1,"i5pciii
.7 . BUILD PER
MECHANICAL PE 28.9t,
F=•[AN CHECv FE t 61 . 2(l USA 0-
SEWER lrjS)!',E.CT 7�5. S'TPEF,.T SVC.
F,`I, S SOC jT'f:jF'%'tj DRAIN SDC
EDW (I.Er,1TON PRIVE LOT 11-91'
TOTAL AMOUNT PAID
ITY OF 'T'CC3f1RD PE:C"FIP'T Of." PAYMU-.NT REC'E.IFT NO. e` (1 .e0)7. 14 ;
NAME; a M l I.I...ER, JAY BLDS'. ]NC:. C A%i AMOUNT t►f►
ADDF;I*ESG P. 0. BOX 2329:1 PAY'MEN'T DAT y 68/c.►2d170
SUP*IYI SIGN t
F'IJPPOSE: OF F'AWIFNT AMOUNT PA ID PURPCOSI:: or PAYMENT AMOUNT T PAI D
� I:'L„F,dN Ghl[:.IW <<f�..._....�..._ ._..._._...._�r'ji'►,���,i -__.._..w..._.._._._......._._.,_.,....._,__.w_.,r.,.,,,,. .... - .._._...�... �
Ii
lI
I
W I: F:N r'Ot l DRI ,T s (R-4 P, LOT Ile—, $V.00.06
0474 ';W ASHFORD 8T, r, st .."F', LOT 51. .
�1�'�;i,t'.it.►
f CITAL. APIOI_INT 00
CITYOFTIFARD
PLM CHEOI< APPLI
COMMUM"T OVOELOPMEMT DEPART ENT % '�"' PLM CHE(X - 1�
a+sa�r.nrai.�/Ae�..mtr t��e•�a� qe Mail T N I) ,
y� DOME ISSUM
JOY ADD": TRX MAP/LOT 3 Fee 0
sue: ��S►1yy C2 _S LOF: // LAM USE:
VALUATION:
OWNER SPECIAL EM
NAME: _ REISSUE OF:
ADDRESS: LAST REISSUE:-
- FLOOD PLAW
PHONE: SENSITIVE LAND:
- - APPROVALS REQUIRED
CONTRACTOR PLAMIING:
NAME: _12.y Miller Builder, Inc. EMUMEERM:
ADDRESS: PO Box 23291 FIRE DEPT
Tigard. OR 97223 OTTER:
PHONE: 641-1992 K M g%gREO
BUILDERS BOARD /: 59667 Ela DATE: 3 f'117 7LIsT/959comwTOR!:
Ws TAX:
ARCH ENG2MEER CM.CULATIOBS:
Nom: TRUSS DETAILS:
ADDREUS: OT?ER:
PHOIMF
OOMMEN M:
SUBCONTRACTORS: PLUMB: zeD Katte %na7a yam„ IE04: nial i poAtin9 nnsA7
PERMIT / ACCT 0 DESCRIPTION AMOUNT AFWMT PD. BAIL. OW
L 10-422 00 Building Permit Feet 11
10-431 00 Plumbing Permit Fees �_�_5 _ 3
10-421 Ol Mechanical Permit Fees - 3
10-22001 stats Building Tarn (ss) ; `(,J _ '.
Building r
Plumbing
Mach
10-422 00 Plans Check FNzk�v
Building ,
Plumbing
Mach
W-202 00 sewer Connection - -`-
20-444 00 •freer Inspection
51-440 00 Street s stem Dov
y Gram (�)
S2--449 00 Parks systme Det CIM" (PDC)
21-45000 stores Drainage syst Bot awl (SW)
10-23006 Fire
TOTAL
4- 7.k� � KCC •APPLICANT 'lRaceived By
aV25Y7►/1N �. orate Beeelted: ; ,
1
CITYOFTIFARD SEWER CONNECTION
A P,E R III IT
'
cny 1W 1WRD
1:IER11117' SWR 90--0286
COMMUNITY DEVELOPMENT DEPARTMENT I::1 R 114. P,E 1-0,1111' It.. SWR 9 0 0 c�8
13125 SW Hall Blvd. P.O.Bac 2'.1347.TOW,Or"m 9",4 03)16?", 171 1)(4TE 06/29/90
152.98 SW KENTON DRCF.4-
2S11.2
ASHFORD OAKS .ZONINUP: PD
1-3 L(]C I'll LUJ.. . . . . . . . . . . . ILAW I ;I-
............ ......
TENANT NAME::. . . .
USP NO. . . « . . . . . ..4 E?-3 2E FIXTURE UNITS. . . 9
C L,0 S G 0F W 0 R K.. 11 E W DWELLING UNITS— -. 1
1 Y V,1::' 0F" USF-''. .. , S F NO. OF' BUILDINGS1
1'N('.')T0I I T Y I:'L.. Li U W I 11VERV GURFACL. f
F.-`III�.l-f,k S
............--- FEES
JAY MILLER type anloulit by date -(,eCp*I;
F'0 BOX 23291. r-44YM $ 1285. 00 '11-H 07/01/90
TI(:T(IRD OR 97(223 TAISP 4> .3'.`:i. 00
JOY MILLER
IT) PDX 23291
T :H3f4RD (.')R 97223 .......- ---
1.11-ic)rie #-. 684---154,3 $ 1.285. 0 0 T OTA L
Rc-!q 0. 30109
REOUIRED INSF'ECT7ONS
!his Applicant agrees to comply with all the ruler, and regulations ',viewer 111sne+r.tilan
of the Unified Sewage Agency. The permit expires 120 days from
the date issued. The total amount paid will be forfeited if the .......
permit expires. The Agency dOPS nOt guarantee the 8CCUTaCy Of the ........ ......
side sever laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from ........... ...........
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit And the Agency will install a lateral.
............................. .........
r III i.I..L e P Si A.;t.k-r
t e cl P y
Ca.11 fo-r irispect:lon 639 41.'75
CITY
OF
TIFA
13125 S.W.Nall Blvd. PLAN PLAN CHECK APPLICATION
RD P.O.Boz 23397 PLAN CHECK
Tigard,Oregon 97223 IST
COMMUNITY DEVELOPMENT DEPARTMENT (503)639-4111 DATE ISSUED _
JOB ADDRESS: / .'7 J ��t fi / ' < ___ TAX MAP/10r _
SUB: _ Lar: 11-2 _ LAND USE:
VALUATION:
OWNER SPECIAL
NAME: _ REISSUE OF:
ADDRESS: LAST REISSUE:
F CID PLAIN/
_ SE N131TIVE LAND:
Pt10NE:
" R IRED
CX?t CTOR PLANNING:
NAME: EIJGINEERIM:
ADDRESS: FIRE UFF�TT -
CUIHER: _
PHONE: �_ I7'kkFS RFJQ(JIRED
B[JILDERS BOARD 0: EX? DATE: LEST/SUBOWIRACIURS: _
BUS TAX:
ARC3i,[_ENGINID2 CAIOXA ONS:
NAME: TRUSS DETAILS:
ADDRESS: 001m:
:
PHONE:
COMMENTS: �. ---
SUBCONTRACTORS: PIIM: MECH:
: -
PERMTT A' ACCT # DESCRIPTION ANDUNT AMOUNT PD. BAL. DUE
_— 10-432 00 Building Permit Fees
— 10-431 00 Plumbing Permit Fees _
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) --
Building
Plumbing _
Mech
10-433 00 Plans Check Fee
Building
Plumbing
Mech
30-202 00 Sewer Connection
-J-- 30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52-449 00 Parks System Dev Charge (PUC)
31-450 00 Storm Drainage Syst Dev Chnl (SSDC)
10-230 06 Fire
MAL
REC ---- _ -
APPLICANT' SIGNATURE ----- ------------
Received By: -. _—___.--.-------.-___--- Date Received:
of/3587P.WPF
rw w w w w w w
GgADING/EROSiQN CONTROL INFORMATION
GENERAL CONTRACTOR NAME&ADDRESS. CASEFILE NO.:
.Inv Miller Builder, Inc. PERMITNO.-
P
nn 97221 APPLICANT NAME AND ADDRESS:
EXCAVATIOI`'CONTRACTOR
NAME& ADDRESS: 0 1
Jim Paulson Excavating Tigard Qr 97223
oute 1 OWNER NAME AND ADDRESS:
Hillsboro, Oregon 97124
TELEPHONE NUMBERS:
APPLICANT,;�$4 7 5 Q 3 PROPERTY DESCRIP►'10N:
OWNER` 6 8 4 7543 STREET ADDS CROSS /LAC TED
GENERAL CONTRACTOR:_6 8 4 75 4 4 '� �~
EXCAVATION CONTRACTOR:6 4 5-1011 �
SITEpOB
LEGAL DESCRIPTION: -\
24 HR/AFTER HOURS EMERGENCY TAX L C'''NO.: L.o
CO'L'Oa e N PERSON,TITLE,TELEPHONE: 1/4 SECTION: _
Eickhoff SITE SIZE,ACRES;_ SSn
`Tab—S i ntend�-�.
� � DISTURBED/WORK AREA,ACRF,S: 3c0a
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAW TO:(CIRCLE ONE)
(NOTE:PO Mrt. MAYBE REQUIRED) CATCH-BASIN I DTICH PIPE CREEK
_ Stumps & brush to l iScf-nrprl
fill area. Dirt to licenses_ PRIVATE PROPERTY
(CIRCLE ONE) P
dump site. UBLICRIGHTOFWA
EROSTONISEDMENT .TION CONTROL (ESC)MEASUREJS,,.
MINIMUM ESC REQUIREMENTS MIMMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEIAPORARY ESC
PERIMETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPF-RA71ON OF PERMANT FACILITIES
CONSTRUCTION SEQUENCE OTHER
OTHER
PLAN FOR EROSION CONTROL PREPARED AND SUBMITIED IN ACCORDANCE WITH TECHNICAL GUIDANCE HANDBOOK%
EROSION CONTROL PLAN DRAWING,AS REQUIRED.HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING GMERGENCY
PHONE NUMBER, SCHEDULE/STAGING POR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND
APPLICABLE STANDARD NOTES.
1 HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSIRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON THE CONSTRUCTIO STfE. I /
CM
OFFICIAL USE ONLY.
RECEIPT DATE ACCEPTED
FEE NUMBER RECEIVED _ BY