12500 SW NORTH DAKOTA STREET .r."",•M+MI.+��+,r•- .� �....+.,,.waw-,•.i.r�•.w'wnwMlmw...�..iw..,....w�,..^w� •.mn- +v.r.s•.w.•�^�v04Y.�11 M�IIM�Mi�!'I�!�MMRYAn"�'+A�rVY
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INSPECTION NOTICE
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Undersl Mech:,Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water/ Line Gyp. Bd. -Mech.
Date Requested:_ -l�,�y��— Timo: ��AM -] /PH
Addceee:_ _Lr / 1 // P. it
Builder: lO� /' l�p
THE FOLLOWING CORRECTIONS ARE RF.QUIR.ED:
_ / L
Lnapector:_
APPROVED DISAPPROVED ��- APPROVED SUBJECT To ABOVE
Call For Rei-nap.
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CMWOF TIGARD � „�
MECHANICAL I CAl_ x'.
COMMUNITY DEVELOPMENT DEPARTMENT 01!,00" #. . . . . . . : MEC 91-056
J FERMI l
• 13126 BW HWI Blvd.P.O.B 23397,TkPM,Onpon 97223(6031939.4176 F l Ft lh 1 T
ac
� ) -41.71 DATE- ISSUED; 10/30/91
SITE ADDRESS. . . : 117:51210 SW NORTH DAKOTA ST PARCEL: 1 S134C9-06600
i SUBDIVISION. . . . : ANTON PARK ZONING: R--7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :28 �
----------------
CLASS`OF+WORK. . :ADD�-K_ --FLOOR�F•URN. . . . - EVAP COOLERS: '
TYPE OF USF:. . . . :SF UNIT HEATERS. . : VENT FANS. . .
' OCCUPANCY GRP. . :R3 VENTS W/O APF'E_: VENT SYSTEMS:
!
STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . ;
FUEL TYPES-------- 0-3 HP. . . . : DOMES. I NC I N: I
: /'GAS/ / / 3-13 HP. . . . : COMML. I NC I N:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
E=IRE. DAMPERS?. . : 30-50 HP. . . . . WOODSTOVES. . ;
GAS; PRESSURE. . . : 504 HP. . . . : CLO DRYERS. . :
1 NO. OF UNI 7 S-- ------- - AIR HANDLING UN I'S OTHER UNITS.
F-URN ( 1O0K RTU: (= 10000 cfm: GAS OUTLETS. : i
FURN ) =100K BTU: ) 1O0000 rfm :
Remar-1(s : INSTALL LOG LIGHTER TO EXISTING FURNACE y
iOwner: ._._._._.____.____.____.___..__._.._._._.___..____._.___.__ ___.._.__._...__..._.._____.__ FEES
JACKIE GLEN type amo�_rnt by de►te r,ecpt
12500 SW NORTH DPK0 FA PRMT ♦ !::5. 00 JL_H 11t)13O191
`,PCT 8 1. 25 JLH 10/30/91 -
I TIGARD OR 97�?23
Phone #:
4,
Contractor-:
BEL_L HEATING INC
15550 SE PIAllA AVE
CLACKMAS OR 97015 _-___---_-----------------------------
Flh o 17 e #: 243- 1184 f 26. 25 TOTAL
Rey #. . 44-1
---_--- REL:•UIRED INSPECTIONS -------
i This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more _..._,__-__�_�,__ _._ _ _.. _•._ __ _ ___
than 186 days.
i
Par-mittee Sigr1eat+ir'e? :
IssLred By :
Call for inspection 639-4175
i
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hain Blvd. APPLICATION Permit # ,
PO Box 23397
Tigard, OR 97223
(503) 639-4171
^p— Description
,~ ct` ,� i'�rr� - Table 3A Mechanical Code QTY PRICE AMT
Job
Address / .I.S�1� S��I ` , '� - 1) Permit Fee -0• -0- 10.00
■
i..� " dt t 1 2) Supplemental Permit 300 I
�^^ Fumace to
�r 1) incl.ducts&vents 6.00
— Fumace 100,000 BTU +
Owner 120:'61 0:'6, 2) incl.ducts&vents 7.50 '
Mrs -P Floor Fumanoe
3) incl. vent 6.00
Suspended heater,wall heater
4) or floor mounted heater 6.00
Occupant w
Vent not Inc.In —
P 5) applianoc permit 3.00
_A-patr ofFieating,ratrig.
6) cooling,absorption unit 6.00
Boiler or comp to 3 HP
�,L_ ;yr 7) absorp.unit to 100,000 B i .1 6.00
""o — /rBoiler or comp to 3 HP- 15
S Sa' -5�� X) ?.. 8) abso,rp.unit to 500,000 BTU 11.00
Contractor URN or comp to 1
9) obsorp,unit.5- 1 million BTU 15.00
au:P4.r~N. •• ^ I er or comp to 30
j4 10) absorp.unit 1 - 1.75 million BTU 22.50
—Moroby acknowledge that I have read this ap Icatlon at�t I er or comp to
information given is convict,that I am the owner or authorized agent 11) absorp.unit 1,750,000 BTU 31.50
of Nie owner,that plans submitted are in compliance with State Air handling unit to
laws,that!am registered with the State Builders' Board,that ft 12) 10,000 CFM 4.50
number given is correct. (If exempt from State rogis"tion,please Air handijing unit
give reason below) 13) 10,000 CTM+ 7.50
Non porta
14) evaporate.=ler 4.50
Vent fan connect
15) to a single dud 3.00
Ventilation system not
16) included in appliance permit 4.50
• Hood seryy
17) mechanical exhaust 4.50
son o new U addition alteration repairomestic FPO
to be done residential t) non-residential Q 181 incinerator 750
xlsUng use o Commercia or In ustna _
building or property ; _ 19) type incinerator 30.00
Other i.e.,woaTtove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4.50
building or property /y
21) Gas piping one to four outlets 2.00 �
Typo of fuel -oil Q natural gas(,-)r" LPG Q electric Q --
22) More than 4-per outlet
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME NUL!AND VOID IF WORK OR
CONSTRUCTION AUTHORIZED IS NOT COMMENCED 5%SURCHARGE t
WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS -
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 PLAN REVIEW 25%OF SUBTOTAL
DAYS AT ANY TIME AFTER WORK IS COMMENCED - ---
TOTA L
Special Conditions
Dale Issued by _
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CITY OF' TICAk.D RECEIPT OF PAYMENT Rt .CE+IPT NO.
CHECK AMOUNT 2G ?!5
CASH AMOUNT 0. 00
NAME'. f3k'I.1 I-aE:A'1'INC' PAYMENT DATE 1
ADDRESS s 15550 !-w P I P Z ZA AVE: SJJBD I V 1131 ON s
C:i._ACE<AMW3, OR 17015....
I-tUR0OSC OF E'AYMEN1 AMOUNT PAID PE..JRV,OSE OF PAYME+Nf AMOUNT PAID
c:5. 00 Sl'. �E►t.11l.lp._.F,�F2 1. ��5
MECHANICAL PE
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SW NORTH DAVOTA
_. _)
FaMfJ1.11�1'T PAID — 26. '.~P5
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C11Y0F TIGARD - CERTIFICATE OF
CRY flit7RD OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT 1'11RM I T t*. . . . , . , t MS r'�1-�►(1►4�
1312E SW Hdl BW P.O.Bac 23:W.nota,Omw -00kep" 7E
t , 25
a 1 TE ADDRESS. iW NORTH DAKOTA T PARCEL t
SUED I V I"331 ON. . . . : ANTON PARK Z ON i NC3 a R 7
BLOCK. . . . . . . . . . o LOT. . * . . . . . . . . . . :28
CLASS OF' WORK. r NEW
TYPE 01 USE. . . :SF
OCCUPANCY C3PP. t R;3
OC:;L:UPANCY t_OAD a 1 18 4
TENANT NAME. . .
Rema,►-k s t
ownerl
.;ACK DORSCY HQMCS
16231 G. OAK 'TREE "rE'RRACE �
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OREGON CITY OR 9704'
Phone #t 656-6450 r
JACK DORSEY HOMES
16231 S. OAK TREE TERRACE
(_)R1-,'GON CITY OR 97045
Kahane iia 656-6450
Pey 0. . , 475.50
E
Occupancy of the above referenerd building is hereby given, and certifieq
the compliance with the State Of Oregon !.pxc:ielty bodes for tk)r+
or.-cupatncy, and use t..inder which the- re.ferenc.:ed F-,ermit was iasupd. E
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FIRE DEPARTMENT t'' U I l...D I NQ I NSF'ECTOR
PO!a T IN CON9P I CUOUS PLACE
� 'e � r•y ,�.I.?ji�� w�vw� r � i � G s, I t Ir Y��rtd� I
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INSPECTION NOTICE td�
City of Tigard Building pepartarscst
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JV/�■y�/y//�/�/� 13125 Sit Ball Blvd. Tl-gard. Oregon 97::23
Inspection Line (Rec-O-Phone: 639--4175 Business Phone: 639-4171
Inspectiont—
PP
A r/Sdwlk
rooting Plbg. Underelab mech. Rough-in
PaCrj {
X66`^�a# d Jvr Pl Top Out Gas Line FINALS
a: round.
:� tr� Y -Bldg.
* p Post/Beam Struct. San. SL
Framing y,
f
Insulation -plumb.
Post/Beam Hoch. Rain Drain
Hach.
J�
Plbq. Underfloor Water Lina Gyp. B �
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PM
f Ay
! S� _Times
Date Requested: O O U"
Permit
Address: a
Builder:_
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TBR FOLLOWING CORRECTIONS ARE REQUIRED: i
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nates
Inspector:_------ --- S
APPROVED
DISAPPROVED APPROVED SUBJECT TO ABOVE
-----
Call For Reinsp.
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INSPECTION NOTICES- -�
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-41.75 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line �PINAL:�
Post/Beam Struct. San. Sewer Framing --Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.)r
Plbg. Underfloor tiater Line Gyp. Bd. -Mach.
Date Requested: Timet �MM PM
Address:
Builder:
r
THE FOLLOWING CORRECTIONS ARE REQUIRKD:
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Inspector: Date:_
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOV`
Call For Reinap.
L�
sum-,
INSPECTION NOTICE _
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-PhoneX• 639-4175 Business Phone: 639-4171
Inspection: �o --
I
Footing Plbg. U/d¢relab Mach. Rough-in `Opr/Sdwlk)
Found. Plbg. Top out Gas Line FINAL:
Foot/Beam Struct. San. Sower. Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
s
Date Requestedt 2 , 25' —'rl- Time: AM PM
Address:_ JZ17� / / , Permit
' M
Builder:
THE FOLLOWING OORRECTIONS ARE REQUIRED:
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p
Inspector:, --_ —.-. -- ---- ._—_
Date:
APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depsitoent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Ph ): 639..4]75 Business Phone: 639•4173
t
Inspection: ----
Footing Plbg. Ivnderslab Mach. Rough-in l' Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach. •
Date Requesteds 7 -�0 r / /- -Time: AM _—_PM
Addreas: �S[JrJ � ��Zl � Permit
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Builders
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THE FOLLOWING CORRECTt NS ARE REQUIRED:
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Inspector:__L.\.Y C.\. .�li Lti _.-----,---- Dates
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
h
Call For Reinnp. 4 r
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INSPEC'YION NOTICE
City of Tigard Building Department
- 13125 811 na.11 Blvd. Tigard, aregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: — �—
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
poet/Boam Struct. San. Sewer Framing -Bldg.
1
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
i
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Date Requestedt
Address: �L/�� IBJ _ -- — Permit t
BuildersTHE FOLLOWING CORRECTIONS ARE REQUIRED:
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4 4"
a a Inspectors - — Date:
yAppROVlD DISAPPROVED V—_ APPROVED SUBJECT TO ABOVE
Call For neinep.
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jNSPECTION.NOTICE
City of Tigard Building uepartaen*
13125 SN Ball Blvd. Tigard, Orogon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections._ .-- -----
Footing Plbg. Underalab ( Mech. Raugh-in " Appr/Sdwlk
Found. Plbg. Tap Out Gae Li f FINAL:
Post/Beam Stcuct. San. Sewer. Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb• r
Plbg. Underfloor Nater Lino Gyp. Bd. -Mech.
Date Requested: -4 S Timet AM _�PM
Address: L �r/_ Permit t e1�
Builders
THE FOLLOWING cORRECTIONS ARE REQUIRED: " tit' 1 7
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Inspectors -��� _- Date: J
APPROVED DISAPPROVED APPROVED SUBGECT TO ABOVF.
q„ Call For Relnsp.
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INSPECTION NOTICE
City of Tigard Building Departoent
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection•Y __-
Footing Plbg. Underelab Mech. Rough-in Appr/3dwlk
Found. Plbg. Tap Out Gas Line FINAL:
Post/Beam S':.ruct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
•
Plbg. Underfloor Water Line Gyp. Rd. -Hoch.
/. -/ ,
Date AequRstedtTitoe• AM _ PH
nn�
7�
Address:��wf7 9 /z Permit 1:
Builder•
L
THE FOLLOWING CORRECTIONS APE REQUIRED:
___ .._ ----moi/� --:-.�-'t���,1�.•� ..�- V`-<-�l�
Inspector:_ 1�� _ Data: _� 7
` PPROVED DISAPPROVED APPROVED SUBJECP TO ABOVE
Call For Reinsp.
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INSPECTION NOTICF
City of Tigard Building 9epartsaent
13125 SW Ball Blvd. Tigard, Oregon 97223 e
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
i
Footing Plbq. Undorelab Mech. Rough-in Appr/Sdwik
Found. Plbg. Top Out Gas Line FINAL:
Poot/Beam 3truct. San. Sewer Framing -Bldg. I
Poet/Beam Mech. Rain Drain •Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mech.
Date Requested: -75- _Time; ( �yh
iM
Address Permit s
—_
Builder:
THE FOLLOWING COR IONS ARE REQUIRED:
!/ f
Tnepectorl Date:S 7
/---�PPROVEb DISAPPROVED APPROVED SUBJECT TO ABOVE )
__Call For Relnap.
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NI SPECTION NOTICE
City of Tigard &Aildfssg Department
131.25 SW Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in App Sr dwlk 1
Found. Plog. Top Out Gail Line FINAL: '
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Inrulation -Plumb. v
•
Plbg. Underfloor Water Line Gyp. Bd. -Hach.
0
Date Requested: l Times AN _ PM
Address: _� � r' l_ - ,e Xv.e�4 1 s
____7—____7— ! /.f'y`%
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Builders_ J
THE IKvLLOWINO CORRE ONS ARE REQUIRED:
S
1 t• GG'�. 'I lam_
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Inspector: L .^ //-� G'_A'CDate: I�
APPROVED DISAPPROVED `1�' tPPROVED SUBJECT TO ABOVE.
i
jCall For Reinap.
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INSPECTION NOTICE
City of Tigard Building Departeent ��
13125 Sw Ball Bled_ Tigard, oregon 97223 i
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171}
"E.
Inspections
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk� fi?'
•
Found. Plbg. Top Out Gas Line FINALe ,,:., _.
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
i'
Date Requested:_ �� �L� Times AM i/PM
Address: 1 2 I �v 'G ` Permit
i
Builder: '
THE FOLLOWING CO CTIONS ARE
rr REQUIRED:
y� CL
Y'�" 1',
11�L I
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1 S IL I t� c
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1 i -Ll 11L•F L�'k ` It I�LS'�,'L�
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Inepectoc: � Dates ---
PROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
Call For Reinap.
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SP ON NOTICE
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223 S
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
`1
Inspections--
Footing
nspection: _Footing ��Plbb�g. Underslab Hoch. Rough-in Appr/Sdwlk
Found. C-Flbg- Top Out Gas Line FINALc
Post/Beam Struct. San. Sewer Framing -Bldg.
w
Post/Beam Hach. Rain Drain Insulation -Plumb.
P�bg. Underfloor water Line/ Oyp. Bd. -Hech.
Data Requested: - - C�L Times 11M PH
U?Z -�7� / I c cel C►G
Aadreee:J� P Xmit it
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Builder:
s
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: ` �__
Date-)^
APPRCVED DISAPPROVED APPROVED SUBJECT TO ABOVE
rfi Call For Reinrp.
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INSPECTION NOTIOR
City of Tigard Building Department
13125 BM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone)t 639-4175 Business Phones 639-4171
Inspect ion s
Footing Plbg. Underelab Mech. Rough-in Appr/Sds•lk i.
!
Found. Plbg. Top out Gas Line FINALS
Post/Beam Strucr_• San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: 4/y -ell
TimesC��,�M
Addresses��S ',T` a Permit
Builders
THE FOLLOWING CO /IONS ARE REQUIRED:
Tnspectors - ( /
Dater '7 2 �_
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep. 4
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,��;�. I�'�i. cif! q ', �li� 3,��yfa�4f��F�14M�.^ •� �1 ;rli r ,i +��.;G� + b.+ti r ,3 'a:; �+�ln��. tr �, t �rS�,Vr �� 2t,�{1.4,
i'p +.- lrrT til'��'�.,l -Uri +q N r ,; 'YJ" i s} ° � k �M-. r r � )o �'f f )� l4 1t� uf,!.I r' N�,Y,'•a,'�"�.
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INSPECTION NOTICE 1 q
City of Tigard Buildlag Departaent
13121 Hall Blvd. Tigard, Oregon 97223
Inspection Line -Phone): 639-4175 Business Phone: 639-4171
Inspections __ —
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
i
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer ) Framing -Bldg.
Post/Beam Mach. dain Drain Insulation -Plumb.
bq. Underil Nater Lino Gyp. Bd. -Mach.
Date Requested: Y�. Time: ---.251_AM PM
—TL
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,f 0i Addrese: ��� .L� c /'�-�+armit is
Builder: zg9e4
THE FOLLOWING CORRECTIONS ARE REQUIRED—
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Inspector: / "/ _ Date: 6 G
APPROVED _Y DISAPPROVED APPROVED SUBJECT TO ABOVE
f
Call For Reinap.
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INSPECTION NOTICE 111`b
_ City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phones 639-4175 Business Phone: 639-4171 j
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
P Found. Plbg. Top Out Lias Line FINAL:
dost/Beam 8trvet San. Sewer Framing -Bldg. 4
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., etRb /Beam Hach. 3 Rain Drain Ineulaticn -Plumb. }
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Plbg. Underfloor Water�iLir.s Gyp. Bd. -Meeh. �(
Date Requested: a Times AN PH
Address: � PLZk-ez Permit #t
A; Builders I
THE FOLLOWING CORRECT NS ARE REQUIRED:
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� Inspectors_
/APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
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INSPECTION NOTICE '" u
City of Tiqard Building Department
" 13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections
M
Footing Plbq. Underslab Mach. Rough-in Appr/Sdwlk G
Plbq. Top Out Gas Line FINALS
Poet/Beam Struct. San. ,fewer Framing -Bldg.
Post/Beam Hoch. Rain i)rain Insulation -Plumb. {
Plbg. Underfloor Water Line Gyp. Bd. -Necis.
Date Requested:_7/� -_Timet : PH I`
� T t
Address:_ `-�� Z2 Z Pershl t��- 1/1/7'
Builders ^ =t
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1
THE FOLLOWING CORRECT NS ARE REQUIRED:
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pt '
4
F
V
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1
Inspectors Date!Date!
APPROVED —` DISAPPROVED APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
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® MASTER PERMIT
C11Y0FT'1FARD CffYOF11A1RD ECRM I T #. . . . . . . . MST91--0049
COMMUNITY DEVELOPMENT DEPARTMENT
M25 SW HON BMd.P.C.eor 29397,Tf PM,Croon OM 001 63W4175 DOTE ISSUED:
ArDDRE55. . . : 12500 SW NORTFI DAKOTA ST I'•APCEL: 1S1 34CPx 066100
sUBD I.V I S I ON. . . . . ANTON PARK ZONING- R-7
fa L-OCK. . . . . . . . . . 1_0r. . . . . . . . . . . . . ..08
_ BUILDING
I(EISSUE:
D�IEL..LIt+l6UNI'Tfi: i BASEMENT. . . . . . . . :0 sf f,' ■
i„LAbb OF' WORK. :NEW BEDRMS t c BATHS:c GARAGE. . . . . . . . . . .440 s f ;
TYPE OF USE. . . :SF FLOOR AREAS--- - - -_.__._ REQUIRED
. . . . s 1 c:1 s i' LEFT. . :5 ft R I GHT. : 1 E3 ft
TYPE OF CONST. :5N F'I RST
,
■
OCCUPANCY GRP. :R;3 SECOND. . . :0 s f F PONT. :20 ft RE=AR. . a f',, ft
( I
i STOP I E5. . . . . . . : 1 THIRD. . . - :0 s f REQU 1 RED-._-------___----______
t ,
rih I GHI . . . . . . . . : 18 ft TOTAL-_.. __.-._.. ; 1 1=, s f SMOKE= DETECTORS. :Y
«-LUOR LOAD. . . . :40 psf VALUE:. . . . . $a 63810 PARKING SPACES. . s0
j
_.__---------------------------------- PLUMPINCr
S1NKS. . . . . . . . . . . I FLOOR DRAINS. . . . :+ SACKFI_OW PREVNTRS. . :'r
LOVATORIES. . . . . :2 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . -2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . .0
WATER CLOSETS. . :c SEWER LINE (ft) . :0 GREASE TRAPS 0 I
D:;SHWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER FIXTLJRES. . . . ,. :0 `
GAHBAGE DISP. . . - 1 RAIN DRAIN (ft) - :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : :! __,._.___
--------------- MECHANICAL _._____-_--_____ ____...____.____-- F E E C7 ___.._.___._. .
FUEL TYPs 5- ------- - UNIT HTRS. . -0 type amount by date recr:t 661
/GAS/ / / VENTS . . . . . 10 PAYM $ 100. 00 JL_H 023/15/91 ::10784 !�
MAX INPUT:O BTU VENT FANS. . :3 BPRT $ 325. 00
E=URN ( 100K . . : 1 HOODS. . . . . . : 1 EiPLC $ c:l 1. 25
f-LJRN i =100K . . :0 WOUDaTOVES. :0 P5PC $ 16. 25
FLUOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 375. 00
i1Oj i../CMP ( :SHF':i1) OTHER UNITS:@ PARK $ 500. viii
GAS OUTLETS: 1 MPRT $ 36. 00
r7wn er: __._._ ________.____-----__.___________- IrIPLC $ 9. 00
JACK DORSEY HOMES M5PC '$ 1. 80
16 :,31 S. OAK TREE. TERRACE_ PPRT• '$ 117. 50
F';PC $ 5. 88
OREGON CITY OR 97045 TiF '$ 13`aih. 00
Phone #: 656-6450 pAYM $ 2847. 68 JLH 03/25/91
,.TACK DORSE.Y HOMES
S. DAK TREE TERRACE
r
ORF:GL)N CITY OR 97045
,I
pjl( ne #: 6 E 64`0
Req #. . 47550
$ 2,947. 68 TOTAL
This per-sit is issued subject to the regulations contained in the •---------- RF_(>.UIRELU INSF'EU11ONS ---- -~�-
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. Ali Nero will.be done in accordance with approved Post/Beam 5tr^Oct Gas Line Insp
pians, This per'sit will expire if work is not started within 188 Wost/be+am Mechem .EnsulAtion Insp a
days of issuance, or if work is 'nr sore than 188 days. Plm/Undslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
f='et•mittee Si.nn.,t : Mer_Fiani.cal Insp Water Line Insp
Plumb Top out App►^/Sdwik Insp
Is,yued By : f.i-ami.ng lnsr) MP1:1) 11iLal Final.
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1 I Call far• inspection - 639-4175
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C17YOFTIGARD LRD CEE"iF.P. CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENTonwoN F•'E-RNI T
w25 BW Iii DA P.O.Bou 23991,'16.,Or Yom+v 1�1 X176 I*,E�R N I,r #t. . . . . . . . SWR 91—O V15 4
t, 9-•41-7 1 D0 7*E. TSSLIED: 03/c'15/91 h
.:311'E {ADDRESS. . . t 12500 S.4 NORTH DOKOTF) ST FIARCE_L: 1 S 134CB-06600
'3UIIDIVTSI0:.1. . . . s ANTON I''l- RK 'ZONING: R-7
F{LOCK. . . . . . . . . . : LUT . . . . . . . . . . . . :28
----------
T ENWNT—NNMt.. . . . . .
:4 ti601 FIXTURE.X'TURE. UNITS. . .
USA NC]. . , . , . . , . • :
':LASS OF WORT'., . . :NEW DWELL I NC UN I Ta. . ; 1 �
7 YF!E OF' USE:. . . . . :SF NO. OF BU I LD I NGS: 1
1NSTOL_L TYf-''E. . . . :BLJSWR IMPERV SURFACE. : sf
Remarks:
I
_lwner; --- ___._.__.____---_._._______._._________.___ FEES
JACK DORSEY HOMES type 'Amco+unt by date rec fat i
1t�c_'. 31
S. UAK IRE:E TERRACE F'RMT $ 1500- OCA
INSF' $ 35. 00
OREGON CITY OR 9704.5 PAYhl $ 1535. 00 JLH 03,/25/r�l �
E�hone #: 656-6450
i-f-)NTRAcTOR NOT CJN F 11..E I�
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h r e
#: fi 1535. 0171 TOTAL
i,'0 Ll #- . :
--- -_- REOUIRED INSPECTIONS ---- e
This Aoolicant agrees to comply with all the rules and regulations newt r Inspect i on
of the Unified Sewage Agency. The persit exeires 120 days from _•._.___.__ _...______.___ .._._._ _ --- —
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not avarantee the accuracy of the _�_•_ _.. _...
side sewer laterals. If the sewer is not located at the measurement
given, tine installer shall prosoect 3 feet In ali directions frog
the distance given. If rot so located, the Installer shall purchase
a "Tap and Side Sewer" permit and the Agency will inssttaall a lateral-
__—
F'e r m it t e e 13 i 1 n 1 L -i e .
ls!s�.red By •
Call for inspectian 639-4175
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CTTY OF TIGARD RECEIPT Of: PAYMENT RECEIPT NC).
CHECK AMOUNT a 4 8,-:"- 68
NOME s DORSEY, ,TACK I:AFiH ISI+1C1lJNT 0. 00
PAYMENT NATE: s 03/.=:5/c;1
ADDRF SE; s aUBD I V I c;I ON s
1.2:)00 NORTH DAKOTA r
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT f+MOUNT PAID
BUILDING PERM� MS'1'91-0049 _ :3125.-00 Pl–UMB I NG PE=RM _wI 17. 50
MECHANICAL, PE 36. 00 ST. BUILD PER 83. 93
FLAN CHECK FE i R,0. 5 SEWL R LISA 1500.00
SEWER INSPECT 715, 0? RE:.'SIDENTIAL TRAF'F'IC FEES 1251. 00
PARKS SI)c 1500. 00 STORM DRAIN SDC 3.75.00 ...
MASS TRANSIT TIF FEES 100. 00
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0110LINT PAID _ _ ...1 43A'e*. �;S I I
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CITY OF T I GARD -- RECEIPT OF PAYMENT RECE:I P'T NO. s91-210784
CHECK AMOUNT a 100, 00
NAME s DORSEY HOMES, INC CAH AMOUNT it 0. 00
ADDRESS s 16231 S OAKTRE=E TERRACE P'AYMEN'T DATE* s 1AS/19/91
SUBDIVISION s f
OREBON CITY, OR 97042.- 12500 SW N. DAKI)TA
I
PURPOSE. OF PAYVILNT AMOUNT PAID F'41RPOSE:. OF PAYMENT AMOUNT P'A1D �
I.'L.AN CHECK FE 3--24R �.....�.__100. 00 .._..._......_.�.._..._.____.__-.._._ __
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'I*oTAI- nMnUNT P'A T.I) — > 1 1,710. ',)o
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