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i:\records\microflm\targets\bui Idirig.doc
CITYCSFTIFICIGARD CEROCCUAfL OF
PANCY
COMMUNITY DEVELOPMENT DEPARTMENT FERMI T 9S#U. . :. .12. MST95- 0-705
DATE ED /20/96
1312f SW Hall Slyd.Tigard,Oregon 97223*8199 1503,639-4171
VIARCELs 21S't04BD---PM005
ITE ADDREGG— s 13774 31W ROSY C'l
JJSD I V 1 S I ON. . . . : ROISE MEADOWS 1 ON I ING:R--7
11-OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . .00,5
CLAS S OF WORK. :NEW
TYPE OF LISE. . . :GF
OCCUPANCY ORP.
OCCUVIANCY LOAD-
Remarks PATIA I
JAY MILLER
P 'J BOX 230459
Y16ARD CIR 97a8l,
Phrit-op #- 684-7543
Con t r--ac t Or: - — --
JAY 01111-LEP
PO DOX 230459
T102AND OR 97281
684 -754a
300 1 @9
!iis Certificate qw•ants oc.cl.ipanev of the abnvp i-pfet-enverl bl.iilciing oir� 'ptotion
'-rpvec)f and confir-ms that the building hat been inspected fut- '-:ompliAnce with
r14* Clitate of Oregon S)pecialtv cedes for., the u)-ol,.tp, occupancl , and usf, unde),
clich the rerov.,onc-'ed P41-mit was issued.
d-I'LDING ING'Pli---C'T0P
P057 IN CJAST,ICIJIXJi VII-ACE
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspaction Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in F=ireplace
Post/Bearr, Struct. Plbg. Top Out Elec. Rough-0 FINAL:
Post/Beam Mech. „an. Sew Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm ater Line Insulation -Mech.
Undertlr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: r _r Time: AM PM
Address:
Builder: ermit #:C;lJoe S� U
THE FOLLO%'flNG CORRECTIONS ARE REOUIREC,
Inspector: Date:
( _APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
`� —Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171 \;
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line dg.
Plbg. Underfloor Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_�d Time: —AM PM
Address: 7� 4r fitClk-
Builder: Permit #: ��—a �O
THE FOLL0VING CORRECTIONS ARE REQUIRED:
r) V zj n
UCC
Inspe Date: Z ��
PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
L
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line tRec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
FOC-.jd00n Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line
Plbg. Unoarfloor Rain Drain Framing
Alarm Water Lire Insulation
Underflr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address: Z2'y 7 5�e .....tea
L, '
Builder: Permit #: 51j--, o t 5
THE FOLLOWING CORRECTIONS ARE REQUIRED:
67)
Inspector: Date:
_APPROVEDyDISAPPROiVED _APPROVED SUBJECT TO ABOVE
all For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line 1dg.
Plbg. Underfloor Rain Drain gaming . lum
Alarm Water Line Insulation eg-e-c-h.
Underflr. Insul. Fhear Wall Gyp. Bd. -Elect.
Date Requested:_ 2 — Time: AM PM
Address:
Builder: ,1 a ' �l 1 �1� t Permit #: �` �; .�G
jji� FOLLOWIP.3 CORRECTIONS ARE RECUIRED:
z5rZ4.5t Q2,1Z141- 3 �Zf!
l"L�1�`!�/y'�i�'� �.�`LJt:�'� Tr•F-f'!_,�C�7�7/ �!1-I�%+�i27' HL�?�CT-C)
�)KR1L L•l; Nc'��1 %
`,g/�>/�''sn%,,�/i���d•-�/- G7��1711 �i f'�.-L,�SIfC _
Inspector: _ Date: I� ,F
_APPROVED _--Q SIjA`PPROVED _APPROVED SUBJECT TO ABOVE
_'GaILFor Reincp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Busir4ss Phone: 63914T71
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing um
Alarm Water Line Insulation "c
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: - Time: AM PM
Address:
c
Builder: �X r l.S"4p— CPermit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
2f t-
44
Inspector: Date: l�
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
,Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. ?E
Date Requested: ( � 1 9, Time: AM PM
Address: l 3 241
Builder7, i4.-J21_�_ fy �o 5_.50 Permit a: C cl S
THE FOLLOWING CORRECTIONS ARE REQUIRE/D:
Ct711 v e Q
I
Inspector: Datejt—�2"K--Z-5,
_APPROVED _DISAPPROVED 4APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTIC /
Inspection Line (Rec-O-Phone): 639-417°, Business Phone: b39.4171 ��V
Inspection: _
Footing Susp. Ceiling Sprink. Rough in �pr/Sdw_lk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Under ioor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. B(. -Elect.
Date Requested: fa �� Time: AM PM
Address:-.3 2 ! q J-' l_ �, -
Builder: Permit p: %s C' 3 CSS
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: `'lDate:y�G r
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call Fo�lnsp.. ____--_
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam St,uct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Bear Mech San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
UndPrflr. Insul, Shear Wall ypT -Elect.
Date Requested:_ 1 L� ' Cj S Time:—AM PM
Address: (/-V
Builder: ermit p: S U 30,S—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
jav
Inspector:-74�� // ��'' Date: 1 P-,'
APPROVED DISAPPHOVED PROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILD114G INSPECTION NOTICE 4.
Inspection Line (Rec-O-Phone,. 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab CVgW Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sower as Lmk; Ta+;t- -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: /cTime: AM PM
Address: 3 -7 7
Builder: �i+ //, k Nl�i Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
p
Aun>ui.eo -L3- VZ.9-r- APJAC-leP ev- z
Inspector: Date: .Zr
APPROVED DISAPPROVED VF'ROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O•Phone): 63q-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Found Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct;C Plbg. Top Out Elec. Rough-in FINAL:
Post/ earn . ech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulatio -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: /U� S Time: AM >__�PM
Address: -7
Builder: __� p p / - %�.52 f Per #: S .3 L/
THE FOLLOWING CORRECTIONS ARE REOUIr.ED:
Inspector: Date:
I>X'PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
,Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Su:p. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
P!bg. Underfloor Rain Drainraming -Plumb.
Alarn, Water Line Insulation -Mech.
Underflr, Insul. Shear Wall p Gyp. Bd. -Elect.
Date Requested: Ll i5 l cf Time:_4AM PM
Address: c
Builder: +] p ( - �fl P mit #: C-3 05-
THE
sTHE FOLLOWING CORRECTIONS
ARE REQUIRED:
Ci3w�rZ X/�'�' �iC.rf)�rC_�'✓ �� ��Z�L.L;.Q/[.�-'t/r
J�
Inspector:/ Date: 16
_APPROVED _DISAPPROVED 4,0 APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection
�Line
a(Rec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb,
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ /6 b 'I Time:--AM PM
'Address: l �p � 67
`�
Builderm Permit #�� y Or}43
THE FOLLOWING CORRECTIONS ARE REQUIRED:
C La
r
Inspector:�4,11 L �? [J rt"r-f Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp. f
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 609.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underfir. Insul. c:]! ear Wa ' Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address:
Builder: c�( ` r7/ 5� / 1 , Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date: /U/
(: -APPROVED _DISAPPRC1VF.0 _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:!
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underclab M,jch. Rough-in Fireplace
Post/Beam Struct. R 6�g; o O Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Z2 L ! 5 Tim AM PM
�7
Address:
Builder: _Permit #: C�.3C�5
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I Spector: Date.
APPROVED _DISAPPROVED APPROVED SUBJ CT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NO"ICE
Inspection Line (Rac-O-Phone): 639-4175 Business Phoma: 639-4191
Inspection:
Footina Susp. Ceiling Sprink. Rough-in Appr/5dwlk
Foundation Plbg. Underslab Mech. Rougn-in Foeplace
Post/Beam Siruct. Plbg. 'Top Out Flec. Rough-in FINAL:
Post/Beam Mech. C��. Gas Line -Bldg.
Plbg. Underfloor _ i3, Framing -Plumb.
Alarm er Insulation -Mech.
Underflr. Insul Shear Wall Gyp. Bd. -Elect.
Date Requested: C~ /�S Time: AM ePM
Address: l ._� % % ` — -- kz
Builder: Permit
THE FOLLOWING CORREC1IONS ARE REQUIRED
Inspector:_/ -G Date:
FIPPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639 4175 Business Phone: 639-4171
Inspection.
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech. Rough-in Fireplace
Post/Bea StgL ruc+. Plbg. Top Out Elec. Rough-in FINAL:
- Post/Beam M ,echSan. Sewer Gas Line -Bldg
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Undeiilr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �'��1 Tune: AM _KFM
Address: `�j��`� 4"< S -, .
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector � Date:
;'APPROVED DISADPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
r
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171 \
Inspection: (_0-a- ( e'l (GJ
Footing / Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
un .alien Plbg. Unders ab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg, Top Out Elec. Rough-ir, FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. ^ Ele-t.
Date Requested:_ ( 7 I f7 S Time> AAM PM
Address:_-) 7 L
Z f,
Builder: Permit M:
THE FOLLOWING CORRECTIONS ARE REQUIRED.
TV L .T ilrrV,�rL 4-.-171 U1= 57 s
Gv��`�-- '-f�i/HJT` E- �=l'c�c`r�s �o✓rc /=�r` fi�S/i%.
leo v -ry P ovF C- -'0 L�-
ze
Inspector: / Date: y S
APPROVED DISAPPROVED /1(PPROVED SUP.IECT TO ABOVE
—Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
o Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Bpam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line insulation -Meth.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_,J� Time: "_AlVF PM
Address: / 3 71 4/_:r S,
Builder: Permit
THE FOLLOWING CORR=CTIONS ARE REQUIRED:
Inspector:_ � ) v Date: -` -rJ
APPROVED _DISAPPROVED '-AT'FAOVED SUBJECT TO ABOVE
_Call For Reinsp.
TER
CITY OF TIGARD PERMITS#. . . .. . . : MST95--0:05
COMMUNITY DEVELOPMENT 0MF1W8NT DATE ISSUED: 08/29/95
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171
PARCEL: 2S1048D-RM005
SITE ADDR1= S:_. . . . 13774 SW ROSY CT
SUBDIVISION. . . . : ROSE MEADOWS TONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :005
---------------------------------- BUILDING
R17-IrSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:4 SATHS:3 GARAGE. . . . . . . . . . : 468 sf
TYPE OF USE. . . a SF FLOOR AREAS---- _______ REQUIRED
TYPE OF CONST. a 5N FIRST. . . . :920 sf LEFT. . :5 ft R I GI IT. :5 ft
OCCUPANCY GRE'. :R3 SECOND. . . :850 sf FRONT. :2 0 ft REAR. . :26 ft
STORIES. . . . . . . e2 F I NBSMENT:0 sf REOU I RED-----------
HEIGHT. . . . . . . . :
ED-•--_-___-_HEIGHT. . . . . . . . : :4 ft TOTAL•-•--------: 1770 sf SMOKE DETECTOR . :Y
FLOOR LOAD. . . . :40 ps f VALUE. . . . . f : 122062 PARKING SPACE'S. . : 1
Remarks: PATH I
____-_---_-------•- ----______...__......_ _.-_. PLUMBING ---------•----.---_-_-_-___--_---.------_-----
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW r,r7rVNTR5. . : 1
LAVATORIES. . . . . e4 WATER HEATERS. . . : 1 TRCAPT;. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . s3 LAUNDRY TRAYS. . . -. 1 CATCH BASINS. . . . . . . :0
WATER CLOSET8. . e3 SEWER LINE (ft ) . :0 GREPSE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FiXTURES. . . . . .0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . it SF RAIN DRAINS. . : 1
----------------- MECHANICAL --________._ __________._____.__.__-- FEES .-. --
FUEL TYPES------------- UNIT HTRS. . :O type amol.rnt by date recpt
/GAS/ / / VENTS . . . . . .0 TIF $ 1590. 00 B 08/29/95 95-269885
MAX INPUTsO BTU VONT FANS. . :4 SWM $ 180. 00 B 08/29/95 95-269885
FURN ( 100K . . - I HOODS. . . . . . . 1 SWM $ 100. 00 B 08/29/95 95-269885
FURN ) =100K . . :0 WOODSTOVES. :0 BPRT $ 490. 50 B 08/29/93 95-269885
FLOOR FURN. . . . :0 CLO DRYERS. : 1 BPLC K 318. 83 BON 08/17/95 95--269463
BOIL/CMP ( 3HP:0 OTHER UNITS: 1 BSPC f 24. 53 B 08/29/95 95--269885
GAS OUTLETS: 1 PARK f 500. 00 B 08/29/95 95-269885
Own e r f 43. 50 B 08/29/95 95-260885
JAY MILLER MPLC $ 10. 88 B 08/29/95 95-269885
P 0 BOX 230459 M5PC $ 2. 18 B 08/29/95 95--269885
3BTH $ 225. 00 B 08/29/97 95-269885
TIGARD OR 97201 p5PC 1 11. :5 B 08/29/95 95-269885
Phone #e 664-7543 EROS $ 64. 00 B 08/29/95 95-269885
Contractor: - - --_____._.__.__________._.__.__....._._ERPC f 20. 80 B 08/29/95 95--269885
JAY MILLER ERPC $ 20. 80 B 08/29/95 95-269885
PO BOX 230459
TIGARD OR 97281
Phone #: 684- 754.3
Reg #. . : 300109 _-..__.--______--_--------------- _-_----
f 3602. 27 TOTAI_
This permit is issued subject to the regulations contained in the ------ -- REQUIRED INSPECTIONS ---- ---
Tigard Municipal Code, State of Ore. Specialty Codes and all other Footing Insp Plr.lmb Top Or_1t
applicable laws. All work will be done in accordance with approved Foundation Insp Framing Insp
plans. This permit will expire if worb is not started within 180 Post/Beam Struct Fireplace Insp
days of issuance, or if work is suspended for more than 190 days. Post/Beam Mechan Gas Line InE p
Crawl Drain Insulation Ir• sp
Permittee L— griatr_1re : _ F'lm/l.lndslab Insp Gyp Board Insp
f�
PLM/Underfloor Rain r1r•�nin Insp
Iys .red By : I`' �!h[cZ� __._.._._. _.. .-._ ._ Mechanic-al Insp Water Line Insp
Call for inspection - 639--4175
-----------
SEWER CONNECTION
M1 T
CITY OF TI� P,ERMIT #. . . : GWR95 -0-357COMMUNITY DEVELOPMENT6 M"94PNT PEC?. . . .DATE ISSUED: 08/29/95
13125 SW Hall Blvd.TIC-ird,Oregon 97223*8199 (503)639-4171
PARCEL: 27S104SD—RM0@5
')ITC ADDRESS. . . . 1:3774 SW ROSY CT
GUBD I V I S I ON. . . . : ROSE MEADOWS ZONING. R-7
BLOCK. . . . . . . . , . . I-OT. . . . . . . . . . . . . :005
TENANT NAME=. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORT:. . . :NEW DWELL.I NG UN T TS. . . I
TyPE.7. OF USE. . . . . :SF NO. OF SUILDINGS: l
I Nf',TALL TYPT-". . - 'BUSWR TMP'I'PV -JURFACE. s f
Remarks: PIATH I
Owner: ------ FEES -- -
JAY MILLER type t�moi.rnt by elate r e c p t
F' 0 r�IOX 230459 PIRMT $ ._'`00. 00 D 08/29/95 95-269885
T N SP, $ 35. 00 D 0a "'r-_'`3/1)5 95-269885
TIGARD OR 972131
Phone #: 684-7543
(:.,,01\jPACTOR NOT ON FILE
17,hone #: $ 2-235. 00 TOTAL
Reiff #. . - I-.-. ,. ,- - REQUIRED INSV,ECTIONS
chis Applicant agrees to comply with all the rules apd regulations Sewer inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer 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 "Sap and Side Sewer" Permit and the Agency will install a lateral.
Oecrn il Lee Sign.AtI.We
e d By
Call. for inspection 639--4175
�- PLUMBING PERMIT
CITY OF T DATE PERMIT ISSUED: .
! 8/295995 -030
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard.Oregon 97223.8199 (503)839.4171 PARCEL: 2S 104BD•-RM005
SIT[' ADDRES a. . . : 13774 SSW ROSY C
SUBDIVISION. . . . : ROSE MEADOWS ZONING: R-7
. . . . . . . . . . . LOT. . . . . . . . . . . . . :005
CLASS OF WORK. . :NEW GARBAGE DTSPOSALS. . : 1
TYPE OF USE. . . . -.SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :1T
STORIES. . . . . . . . :` WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES•-----•------------ LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
!.AVATORIES. . . . . :4 OTHER FIXTURES. . . . . ;0
TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : Y'ATI1 I
OWNER: ___ _-__--•--.---__ -___.___________. _.._________._._._____FEES---_____-----_..
JAY MILLER TIF $ I'DZI. 00 B 08/2q/95 95-269885
P 0 BOX 230459 SWM $ 130. 00 B 08/89/95 95-•69885
SWM $ 100. 00 B 08/29/95 j5-2691385
TIGARD OR 9781 SPRT $ 490. 50 B 08/29/95 95-269885
Phone #: 684-75433 BPLC $ 318. 83 BON 08/17/95 95-269463
p5PC $ 24. 53 B 08/29/95 95--869885
1='1�_Imbing Cont Tactor:_______._.---..___..____- PARI', $ 500. 00 B 08/c9i95 95--269885
MPRT $ 43. 50 B 08/89/95 95-269885
Name . t'17 It'a) A, // 11PLC 3 10. 86 B 08/29/95 95•-269885
Addr^esst '&er- `;C? a7S M5PC $ 2. 18 B 08/29/95 '15-269885
City :• 10 ag" State : �i _ 3ATH $ 2,_5. 00 H 08/29/99 95-269885
Zip: Phone#: >r�S�1'�/�/�/ P5PC $ 11. : 5 B 08/29/95 95-269885
Reg #: = Additional fees not shown here. . . . . . . . .
------- REOUIRED INSPECTIONS -------
This permit is issued subject to the reg-
ulations contained in the Tigard Municipal Footing Insp Insulation Insp
Code, State of Ore. Specialty Codes and all Foundation Insp Gyp Board Insp
uther applicable laws. All work will be done Post/Beam Struct Rain drain Insp
in accordance with approved plans. This Post /Beam Mechan Water Line Insp
permit will expire if work is not started Crawl Drain Water Service In
within 180 days of issuance, or if work is Plm/undslab Tnsp Appr/Gdwlk Insp
suspended for more than 180 days. PLM/Underfloor Mechanical Fina]
Mechanical Insp Plumb Final
Plumb Top Out Building Final
Framing Insp Erosion Control
Fireplace Insp _ .....
Gas Line Insp
Authorized Plumb>.ng Cont ct0l- Signature
Call for inspection 639-4175
Contractor Notes :
L
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigar J, OR 97223 Planck/Rec. # ! ("016
Permit # (c Ys ).2lf
Phone (5U3) 639-4171 Date Issued ` , 241 ' 6 _
CITY OF TIOARD TDD
(503) 684-7297 !sued by t I�174-
TDD No. (503) 684-27,7 2
Inspection (503) 639-4175
1. Job Address: f 4. Complete Fee Schedule Below:
Name of Development � Number of Inspe.Aions per permit allowed
Address_I >> /,/I/ �W 1 j�`�1� �� ServlcFt IncludHd Items Cost(ea) Sum
City/State./Zip_ /� �) 4s. Residential-per unit ff�rY' 4
11 l I p�7 1000 sq 1t or lees _i $11000
Name (or name of business)J t t/ M l 1 IT'( !/JL�'1�, l L!C- Each addrionel 500 eq rl or
portion Ihoreol $2500 1
Commercial❑ Residential(hl Limited Energy $2500 �.
77 Each Manuld Home or Modular 2
Dwallm0 Service or Faadar $68 00
2a Contractor Installation only:
_ Qb.Services or Feeders
Irntallalion,alteration.or relocation 2
Flectrical Contractor L ^I c, 1v % 200 amps or less $00 00 2
Addf tN ( 201 amps to 400 amps $8000 2
Cl State ZI I .� 401 amps to 600 amps $12000 2
`7 p 601 amps to 1000 amps $16000 2
Phone No..-)g)- -1 Diver 1000 amps or volts $94000 2
Contractor's License No. � 17 G Reconnect only $5000
Contractor's Board Reg. No. 4c. Temporary Services or Feeders
-7 Installation aflerahon.or relocation 2
'ignature of Supr. Elec'n� _ -!r ��?,�J ;. 200amp<orless $5000 2
License No. �� 1`� Phone No. p2�- P_`f16- 201 amps to 400 ars 00 _ 2
401 amps to 600 amps $100too 00 _
(Nor 600 amps to 1000 volts
2b. For owner installations: see-b-atXNP
4d. Branch Circuits
Print Owner's Name _ N" alteration or extension pen panel
Address al The lee for branch circuits wife
city State. ZipV purchase of sanies,or Mader Ars. 2
`� -- — -------- Each branch circuit $1,00
Phone N0. _ h)The fee for branch circuits withouf ,
The installation is bein J made on property I own which is purchase or service or leader W. 2
Punt branch circuit $35 00 2
not Intended for Sale, lease Or fent, tach additional branch crrcu�t �� S5 00
(Tuner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or irnpa!ron rordri $4000 2
Each sign or outline lighting $4000
Signal cimud(s)or n limited energy 2
Please check appropriate item and enter fee in section 5B. panel,allarahon or exten.;ion $4000
_4 or more residential units in one structure Minor Labals(10) _ _ $10000
Service.ind feeder 225 amps or more
System o or 6(n volts nominal 4f. Each additional inspection ovar
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E.0 Chapter 5 Par vwpsclion $3500
Per hour $5500
Submit 2 seta of plans with application where any of the above In Plant $5500
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $
5%Surcharge(05 X total fees) $ (,j
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subfofal $ —
AU rHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Pi4view if required(Sec 3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account p
Balance Due g j 1
.narroaxlrwl.cprm.00
_Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd._
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Subdivision: Office Use Only
r ��- �� �� ����- � Lot # r r
Planck/Rec #
Valuation: Z U ;,Z _
`, Permit # �
Flag Lot? r LN
Corner Lot? Y -
(N / Reissue of
Map & TL #
_l
Owner: jo 1� (ti� ,i�! i �(�iV 1 1(_ — Approvals Required
Address: i i_ ` 11 Planning
Engineering
Phone: L -
Other
Contractor: 11;° �.- — Items Required
Address: _— Subcontractors
Truss Details
Phone: Other
Contractor's License #
(attach copy of current 0regon license)
Contact Name & Phone:
Subcontractors: Architect/Engineer: 0-C,ll ")
f 1
Plumbing: 11� 1 �� I��`� ��� �� Address: x
Mechanical�;,,� I �f Ll
(attach copy of current ORContractor's License) / .
Phone:
JOB DESCRIPTION: ��`�
Applicant Signature
n&nPhone number
Received by:, Date Received:
WWORDCOMOFV\RESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
7)
State Tax (TAX) ' 3 7 y i
u',,1 g: L;3
Plumb:
Mech: ? '�
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA) 7,20�'
Sewer Inspection (SWINSP) -.1
Parks Dea Charge (PKSDC)
r'
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) 1{' _� C
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
i
Erosion Planck/USA (ERPLAN) � —
Erosion Planck/COT (ER06N) , v
a�
TOTALS:
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