10950 SW NAEVE STREET-1 Mq
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r CITY OF TIGARD BUILD I S ECNOTICE �I�� " ^� � 5
Inspection Line (Rec O Phone): 63)-4175 Business Phone 71 + ,,,gar „
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Inspection:
Footing Susp. aing Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace 4r A
+� Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: ,r t
tlf Post/Beam Mech. San. Sewer Gas Line -Bldg. tk�
Plbg. Underfloor Rain Drain Framing -Plumb. * " •
I Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time:--AM PM
Address:
Builder: Pormit k
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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ctora Date:
PPROVED _DISAPPROVED _APPROVED SUBJE TO ABOVE i
_Call For Reinsp.
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DING
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CITY of TIGARD PFRr1ITUI#L.. . . . . . . BUP'3`.-,--0048 ~ ~
CQMMUNITY DEVELOPMENT DEPARTMENT D()TrE ISSUED: it'r.-r/05/95
13125 SW Hall Blvd.Tigard,Oregon 97223x8199 (503)839-4171
PARCEL: GS110DD- 13900
I1DDRES': . . . ., 10950 SW NAE=V E 5T
SUBDIVISION. . . . : SUMMERS I ELD 1\10. 14 ZONING: R-••25 PD
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :709 .
REISSUE:~ _______ FLOOR EXTERIOR-----� EXTERIOR WALL C(3NSTRUCTION
CLASS OF WORK. :aKD c- FIRST. . . . f N: a: E : W:
TYPE OF USE. . . SECOND. . . : Sf P,IRO'TECT OF,ENING''S?----------•_-•-
TYPE OF CONST. :5N THIRD. . . . : S N. S. E: W:
OCCUPANCY GRP. :R3 TOTAL-----.._-.--: ;f ROOF CONST : 17IRC: RET'?:
OCCUPANCY LOAD: BASEMENT. : S f AREA SEF'. RATED
F IT. : 1 1 Ft CiAFiAGfa. . . : n f'
f 166. . i C1CCU SEP,. RATED:
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PSM-f'?» MEZ27 : READ SETBACKS---- ---------- RCUUIRED-_____._...._-_____....._.___
FLOOR LOAD. , . . : ps'(• LEFT- ft RGHT: ft FIR .IF'KI_: SMOK DET. . :
DWELLING UNITa: FRI\I-f » ft REAR: ft. FIR ALRM: HN;)ICF' ACC:
I►EJRI',1S: LATHS: IIID SURFACE;: F'RO CORI?. PARKING:
VALUE. $ : 1600
Rr:mar~ks; : roofing deck 2104 sq ft rouf
Owner: -- ---- - ____.____..___,__._.__.._____.________.____ ____---_. _-- FEES •__..______._.____..._
PETER ADAMSKI type Aolo�.rnt I,y da< e recpt R
1.0950 SW NAEVE: ST PRMT $ 26. 50 BON 07/03/95 95-2675t2
PL.CK t 17. 23 BON 0'7/lb3/93 j 95--2&75 t2
.1. 1L;ARD OR 97223 5PCT $ 1. 33 BON 07/03/95 95-267312 �
SontriActcir:
K t4 G 1.NC
503 NE~ THOMPSON
PORTLAND OR 97214'
45. 0G TO'AL.
Rrrag #. . 104:391
------- REQJIRED INSPECTIONS ---
This permit is issued subject to the regulations container, in the F'ram:ing Inc>p _
k Tigard Municipal Code, State of Ore. Specialty Codes and all other Re in drA i n I n sip
' applicable laws. All work will be done in accordance with Fi1.aI Inapection
approved plays. This permit; will expire if work is not stated
within 180 days of issuance, or if work is suspended for sore
t,. than 160 days.
I'er-mine;? unEAI; ..rr _.. .
d 1.y A— UD'rRX4A.
q Call for inc-pertion 6.39-417 ,
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Residential E3uildin Permit Application
► City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 �
Jobsite Address Lo
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Office Use Only
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Subdivision: Lot#
Contact Date / 1 Initials _
1
Valuation: (�, 6U ___ Result
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Planck/Rec # 1 -
New Construction only: (Square Footage) Permit # --4LTISL2 d kReissue of --
House: Garage: —_ Map & TL#
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Zone —2m.
CND
� Plat #
Corner Lot? Y F129 Lot? Y N
ApprovalsRequire,i
Owner: �.�2ti'-t�_ 1 1 �� ��
Planning Setbacks _�.,_ Solar i
Address: -��2_�Z' �L�J r'' � Engineering _ — -
` Other --- --
Items Required
Phone: L� ) (�7 � � � � —
1 " Subcontractors
Contractor: '` Truss Details -
�- Other
Address: ( —
�. Notes
Phone
Contractor's License #
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(attAch, op of current Oregon license)
Contact Name: Cl ,
Contact Phone:
ArchitectlEngineer:
Subcontractors: d II
Address.
Plumbing: - I
Mechanical: _ —
(attach copy of current OR Contractor's License) Phone:,(
JOB DE jGRIPTiO 4t '7Z Cr d c f
A plicant Signature Applicant Phone number
Received by: r J��.4 Date Received:
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Bal.'Lu�
permit0Account Description Amount Amt.Ptt._ . /
vup = 02 Y Bldg. Permit (BUILD) �?l %S U
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Plumb.Permit (PLUMB) —
Mech. Permit ( ) -- ---
state Tax (TAX)
Bldg: w
Plumb:
Mach: / e
Plan Check (PLANCK)
Bldg: -
Plumb:
Mach:
Soarer Conn4wdan (SWUSA)
.s
Sewer Inspa�:tlon (SWINSP)
Parks Dev Charge (PKSDC)
Residential •nF (TIF-t)
Mass Transit TIF (TIF-MT) ----
Commercial TIF (TIF-C) — —
Industrial T11' (TIF4) --• —
Institutional TIF (TIF-IS) — -- ---- ---
office TIF (TIF-0) ------- —___ -
Y
Water Quality (WOUAL) — —
Water Quantity (WOUANT) _ — --
I
Firs Life SafRty (FLS) ---- -
Erosion Cntii Permit (ERPIRMT) — ------
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Erosion Planck/USA (ERPLAN) _ ---
Erosion Planck/COT (EROSN) -- - i
TOTALS:
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PLAN CHECK FEES LIST i
PLAN CHECK# 7 j PERMIT# DATE 7 / S / 5'
ADDRESS /o;-so _S�v�C '✓ —
TAX/MAP/LOT e� /u
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SUBDIVISION LOT # LAND USE
�`C�m�+✓� {-��/� u —
VALUALATION�G�,, = .SETBACK FRONT—REAR—LEFT—RIGHT
WORK CLLSS I HEIGHT TOTAL AREA_
S f FLOOR LOAD - 1st FLOOR_ 104
USE TYPE___
CONST TYPE d /A HEAT TYPE 2nd FLOOR^ _
OCCUP GROUP") DWELL/UNITS - —3rd FLOOR —
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OCCUP LOADBED ROOM 3ASEMENT —
STORIES_ - I .--BATHS----.--3ARAGE� _---
PERMIT # DESCRIPTION AMOUNT AMOUNT PD BAL DUE
BUILING PERMIT FEES —
/� _ PLUMB PEP.MIT FEES --.
MECH PERMIT FEES —
j STATES BUILD TAX
BUILDING _
PLUMBING`_
MECHIAVICAL
PLAN CHECK FEES /7 Z 23
BUILDING_
PLUMBING
MECH I ANCA.L�__��
SEWER CONNECTION FEE
SEWER :INSPECTION FEE
PARKS _
RESIDENTIAL TIF --
MASS TIlANSIT — —
WATER QUALITY
WATER QUANTITY _
EROSION CNTRL PERMIT _
EROS ION PLAN CK USA
tea EROSION PLAN CK COT —_
TOTALS
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CITY OF TIGARD Fpur IC''•T CIF- PlOYMENT RF"CFTPT' NO. 19,5-267511?
C'Iir(.K AMOUNT s 45s. 06
PCAME s NMG CONSTRUCTICM C"-W"ill flMOUNT CA. 00
ADD RE;ISS s 650t, SW 179TE4 PVF. PAYMENT DATE 07/03/955
ALOHA, OR ''M'•.►D T V I f~;I ON a
V URF''OSE OF PAYMENT 0MOL1NT PA I L7 PURK'OSF., CIF' PAYMENT OMOLINT PAID 1I
2 "' � r1._�N CHBUILDIN(i PERM 7 17. i?, f
',3T. B(J I1.11 PER 1. 371,
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