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INSPECTION NOTICE
City of Tigard Building Department
` 1242C S.W. Ma'n St.
Tigard,Oregor. 97223
Phone: C:,9-4171
Tvpe of Inspection --' ? Q .o
C •te Requested _ Time A.M. _F
Permit # _
Address -
Owner_— . Lot #
Builder - — —
The following Building Code deficiencies are required to be corrected:
I _ �
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Presented to _�� — — /Approved
Inspo-tor _-- '` __ � Disapproved
Date
CALL FOR REINSPECTION
O YES ZNO
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BUILDING PERMIT APPLICATION TIGARD DATE ::i;.,_ i9_ ,y4 4943
THE UNDERSIGNED MI-FIERY APPLIES FOR A PERMIT F(�R-1 HE WORK HEREIN INDICATED BUILDER PHONE _ti2U-1242
OR AS SOOWN AND APPROVED!N THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNERPr�t�tun c:ut:I,iliB JOB ADDRESS �9443 SW Kimberly Ur.
NO.-_- _ ---
-- ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
S. iRE L_] NEW EiREMODEL 17 ADDITION El REPAIR ❑ RENEWAL CI FIRE DAMAGE_ 0 DEMOLITION
C.kReSIUENCE ❑ COMM EJ EDUCATIONAL ❑ GOV'T O RELIGIOUS C.] PATIO ❑ CARPORT f] GARAGE 0 STORAGE EI SLAB❑ FENCE
OCCUPANCY _ � _LAND USE ZONE —A--7 —BLDG.TYPE FIRE ZONE, -PLAN CHECK dY HEAT_ ti�I1B
Addition tO exiatin.j Si&nle f _ly ltwelliug wood flour — crawl aJ�ac,�.
SEWER PERMIT M - 140 Pltupbing
OCC.LOAD ''BOOR LOAD 40 HEIGHT _ I6+NO.STORIES I AREA 440 NO.BEDROOMS _ VALUE 4,UOO.
buii_i,..irGUEPARTMENT SET BACKS�FRONT REAR _LEFTSIDE i 13 RIGHT SIDE j(
-- — - _
Permit 44.51) _----
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PIP,n Check •8.93 WORK WILL BE DONE IN ACCORDANCE WITH Tt•IE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 73.43 RESTR"'rIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State 7r ,.1t;
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
c
Total -- — 1.5.2► SDC--
Y PVC# APPLIC, ORAOEFT— -. -- —
By f„t
Approved t, !hl Receipt Nn ADDRESS
PHONE
� tael e r
DATE INSP. TYPE INSPECTION REMARKS PLUMBING I DATE
Q _ { Contractor —
Permit No.
��� � •>Lvt• _��`�
Rough-in
Fixture
Final
------
HEATING
'�x.Jlyrli/1'L� d�?/at ri✓i(: �'O/(/:�"T! >.rFl��� ' Contractor 4
(,>� /I y' �. . Permit No. —
Gas or Oil
Final
-- SEWER
Final
DRIVEWAY
Final — — —
__ —i Storm Drainage
,Hein Dain)Final
Sidewalk
Curb&Street Final
Approach —
BLDG. 'U,EPT. F'INAT_ _ TEMPORARY CEF;TIFICATE OCCUPANCY
iCERTIFICATE OCCUPANCY Final
i Landscapi^y
iZoni q Final
EWA
TIGARD DATE- -
BUILDING PERMIT APPLICATIONx,20
THE UNDERSIGNED HEREBYAPPLIES FOR A PERIAIT FOR Tk.E WORK HEREIN INDICATED BUILDER HONE —�
OR A5 SHOWN AN PPROVED IN THE ACC011PANYING PLANS AND PES FICATION: LOT —
�+ ���Q� __ Q/flrj
O•NNERP✓AA41/' b-_� -fig ADDRESS ARCHITECT
ENGINEER
DESIGNER _
RUILDER
ADDRESS _�__�-- --
XFRIEEMODELADDITION 0-REPAIR ❑ RENEWAL. ❑ FIRE DAMAGE QE►.IOLITI01•STRUCTURE ❑ NEW - ❑----_-2N ---- - -
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GAR4GE ❑ STORAGE ❑ SLAB❑ FENCE
_-- - _ - - —
C}u.iiPANCY 2�A��NO 11SE 20NE .-BLDG.TYPE r __FIRC-ZONE_'F_"•�'CHECK B HEAT
SEWER PERMIT k --- O Q�
ARE\ NO.BEDROOMS VA.LLIe
OCC,LOAD HEIGHT 'Jf" NO STORIES L- --
FLOOR LOAD (f� G -- RIGHT SIDE rU
- LEFT SICF_
-BUILDINGDEPARTM�NT- SETBACKS FRONTREAR _--- - _--- ---- --
Permit y TO THIS PERMIT IS ISSUEq SUBJECT TO THE REGULATIONS CONTAINED IN THE SUILDING CODE,ZOW!4:
+1 RFISPERMIT ILATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT Tt:'
PlanCheck - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN (:OIdPLIAt1C
F- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIS
RESTRICTIVE LICENSE.SEPARATE ANTSPERM.COREOUIRT 0 FOR S EWER,PLUMBNG AND HEATINGNTRACOR AND SUB CONTRACTORS TO HAVE . CI rr BUSINcS
Total _ / y7 1 "� PD( APPLICANT OR AGENT
BY -- -_
Receipt No. ApORESS F'HOI:�
Approve4
SDC____
PUC - —
SEWER CONNECTION_ 5 r f
SLWER INSPECTIONew
SEWER SURCHARGE 5 _-_---
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~ APPROVED FOR CONSTRUCTION`+
CITY OF TIGARD ' R
PERMIT NO._-- SITE ADDRESS
BY _TITLE DATE j
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ddrez3s q?43 CU P rr.,j.t 1!L) 13 Fs 7 :2____.
Permit charge 7
r.nnnection fee
Poid by
i.d n z .sem Date corner gd
lrvice rr, InoPection fee
nntrar_tor Paid by date
A ze of nonnTction Assessment Paid
2,15
4
w� � ■w +ate �r wlll .� .+rl ,Iii
.`_. ....r,.„.Fr ,..��.SA^'1 •-vA.�.......-�-^- r.,.r_..._,,..___"„�,F,�,.-, ,,.R'+*+1�IAs1Rc�+Mw1�.«wil�4vpr"".eg"^,J"'^bYtriaL4 .WkM�^ �{R` �.5�'., 'u9+tP+M?..+;,q. ,:�. -_ _.'i7
BUILDING PERMIT APPLICA r ION cOF TIGAR"J DATE— a, r� 7c,
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED 13UILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANU SPECIFICATIONS OWNERPHONE�
LOT NO—
OWNER -irri1'!traphE Inc. JOB ADDRESS " 'a PMOAIE ADDRESS _
ARCHITECT
ENGINEER
BUILDER ADDRESS — DESIGNER —
STRUCTURE ❑NEW 0 R MODEL ❑ADDITION ❑REPAIR ❑RENEWAL-- ❑FIRE DAMAGE —❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL 0GOV'1 ❑RELIGIOUS❑PATIO [-]CAR PORT ❑GARP of ❑STORAGE❑SLAB ❑FENCE
LeRC VO ❑MOVING ❑CONDITIONAL. USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ ❑SIGNS
OCCUPANCY LAND USE ZONE 'i BLDG.TYPEIRE ZONE:;._PLAN CHECK BY_ - HEAT___u___ _
�—
�'� >M160tr. um
QCT L4A4 FI,QQf3_I C�A_C2 —_._�lE1CzHT _ 1VIQEIE� l31AC�ACI __rt_yALUE « 4600
BUILDING DEPARTMENT
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE �
Permit 1.97.00
-- ` THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINSD IN THE BUILDING CODE, ZONING
Plan Check EI REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TNA: THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS 'NE)IN COMPL IANCF WITH
Subtotal HI_I_ APPLICABi.F CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NO1 WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTt1ACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 1+ LICENSE. SFPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total .(
BV — —---
APPLICANT OR AG7I�T
Approved i Receipt No. 1911
—" A SS
ww ilei ■eer ee� e�w � � .e e� e�
DATE INSP. TYPE INSPECTION — REMARKS PLUMBING DATE
Contractor------ _ - -
�_
Permit No. Al 1,5- (� S ��
�- ' Rough-in
Fee
11
Fixture
Final
HEATING _---
-^�
Contractor
Permit Na.! 3
Gas or Oil
Rough-in
Final _
- --- —._-- -- -- ---SEWER
--
Final
— - --- - -- ---- - - DRIVEWAY - -
Final
— Storm Drainage
---- -- �-- ---- (Rain Drain)Final --- -�
Sidewalk
Curb R Street Final
-- -- -'- --- ----- APPnmch
BLDG
T.FINAL — fiEiIPORARY CERTIFICATE OCCUPANCY I Final
CERTIFICATE OCCUPANCY ---------
Landscaping
Zoning Final
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SEWER PERMIT NU 15877
Uf ni'sd Sew�rag a Ag*ncy T I G A R D A r i l 26, 1978
of `Vaahington County CITY OF DA'f E
OWNER : _ jonsteoh. Tnc. PHONE :
OWNER 'S ADDRESS: 9843 SW Kimberly Dr.
TYPE OF INSTALLATION:
❑ BUILDING SEWER ❑ BUILDING SEWER .AND SIDE SEWER
TYPE OF OCCUPANCY:
D NFW ® SINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. WRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTUkE UNITS DWELLING UNITSL.___
ADDRESS OF STRUCTURE :
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGEi,,CY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRFD AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FFI-S:
PERMIT FEE $ 600, 0
CONNECTION CHARGE 25. 00 ----��----
SIDE SEWER INSTALLATION -.__��c��.�,tn
SUED BY
OTHLR
TOTAL $ 625. 00
) -/_!�4,- h, �— ) 4-26-78
APPLIC T -� r DATE
He
CHARGE lrll QECIAFOA IfHl3 N° 15877
PERMIT SEWER PF RMIT
ADDRESS OF STRUCTURE 9843 SW Kimberly Dr .
TAX MAP _ TAX LOT SYSTEM
LOT BLOCK OF , J
L. Walden 4-26-'70 _ ` J F,)cl. k Q - ' c; -J kY
,APPROVED BY DATE ISSUED BY DATE
' S _ 1 — REMARKS EI.:��_ iggnc;a
Jll_LliNG F)LRMIT APPLICATION c�Y RDD ATEQ N° ?
,IF LINDF REIGNED HEREBY APPI. IES FOR APF_RMI i FOR THE WORK I,t-RFIN INDICATED BUILDER PHONE _
AS SHS '�� ANE.' APPROVED IN 'THE ACCOM .+HYING PLANS AND SPECK ICAlIONS. OWNER PHONF -..
LOT NO._
Z < JOB ADU17E55 �S�(/`/L, t�E ADLJRC55
ARCHITECT
LNG NEER
R ADDRESS _ DF:.SIGNER
1
0NFL-
W TQ RE MODE �_. DADDITION LJHEPAIR RENEWAL ❑F IRE DAMAGE []DEMOLITION
(� r1MM LJ
❑EDUCATIONAL OGOV'T RELIGIOUSOPATIO ❑CARPORT ❑GARAGE C]STORAGEEISLAB []FENCE
Dnn_
`ND []MOVING ❑CONDITIONAL USE ODLSIGN REVIEW COUNCIL APPROVED ❑SIGNS
I' NCY LLAND USE ZONE—?-" BLDG.T','PE FIRE •LONE PLAN CHECK BY
AU - -. F4gQPl.U�Q- ----NEAC�lY - NQ..STSlRI��---.APEAr90--Y- iEgp40M� �uEt�~��- �
PUILUING DEPARTMENT 7
SET BACKS A,90--Y-
F �.O REAR IFFT SIDE RIGHT SIDE '7
THIS PFRMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDINU CODE, TONING
liar: Check REGULATIONS AND ALL APPI ICABLE CODFS AND ORDINANCES, AND IT IS HE FIERY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPFCIFICATIONS AND IN COMPLIANCE WITH
`,uh iota( — -- `^ ALL APPI ICABLE CCOLS AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RLSTRIGTIVF COVENANTS CONTRACTOR AND SOB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
,iai—Tax LICENSE SEPARATE PF RMITS REOUIRED FOR SFWFR, PLUMBING AND HEATING.
J�
_ APPI ICANT OW AGENT
Receipt No
Phil ir,r SS
f � r` /