8785 SW REILING STREET 5785 SW REILINC STREET
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CIrlTY OF TIGARD Pfr)lt,)x 7-1397
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7igard,Oregon97:.'_3 PERMIT #
i3OMMUNI'Tl' 1)I �'F,I,f)PMGNT DI;1'ARTMI?N'1' (503)639-4171 PATE ISSUED
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TAX MAP/LOT ---
JOB ADDRESS:
SUB LOT: LAND USE:
___7�' -
VALUATION:
OWNER r SPECIAL IJOTES
NAME: l'1 l uISSUE OF:
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ADDRESS: � s_�r�fd� ' mss. --�� LAST REISSUE: __,-.---
-� FLOOD PLAIN/ — - -
SENSITIVE LAND:
PHONE:
CO_NTRAC APPROVALSREQUIRED
PLANNING:
NAME:
ENGINEERING: --_--
ADDRESS: �� .-
� FIRE DEPT: _
OTHER:
PHONE: -
CONTR. 90ARD #: ��a/ EXP DATE: Al2-1' 9`1
LTEMS REQU I RED
SUBCONiRACRI S: PLUMB: - � �- �- (-IST/SUBCONTRACTORS:
i --- MECH: ( _ BUS TAX:
ARUANG-1NEFR CALCULATIQNS:•,
NAW: :�/tt r t ( ��/:d� • TRUSS DE ILS:
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PHONE: _r
PROPWED BLDG USE: _ -- -----�
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g PLICANT SIGNATURE
Date Received:
Received By: _
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432. 00 Building Permit Fees 1L✓,` _— 1jv ' '�
10-431 00 Plumbing Permit Fees X1.1 — ?�
10-431 01 Mechanical Permit Fees -----
10-230 01 State Building Tax (5%)
Building
Plumbing _ h,
Mechanical
10-433 00 Plans Check Fee
Building -7f, t 3
Plumbing
Mechanical
10-230 06 Fire --
30-202 00 Sewer Connec.i.ion -
30-444 00 Sewer Inspect;on _-- — ------
25-448-02 Commercial TIF Fees ---
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees _ __-
25-448.01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52.-449 00 Parks System Dev Charge (PUC) -
31-450 09 Sca rm Drainage Syst Dav Chrg
(SSDC) _ --
24-445-01 Water Quality (Fee in lieu of)
24-445 -02 Water Quantity (Fee in lieu of)
TOTALl -K2
r.111%3' ,P.WPF
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A M..._—,P.M.
Address Permit
Owner
Lot #
Builder
The following Building Code deficiencies are required to be corrected:
C– I
4
Presented to Approved
Inspevor Disapproved
Vatri
CALL FOR REINSPECTION
17 YES NO
INSPECTION NOTICE �
I
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
I Type of Inspection -
I t> j
Date Requested—�: 2 Time--.X A.M. P.M.
Address _ J� :2 1 kl Permit #
Owner, -- __—_— I.ot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to ._ _ _ ❑ Approved
Inspector _ �C— _. [ Disapproved
Date
CALL FO t REINSPECTION
{ YES F� NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested –' q Time_ A.M. P.M.
Address __ cii" 2.S'–S 1 4r t �zd 'i� Permit #_ —
Lot #
Builder
The following Building Code deficiencies are i Squired to be corrected:
.._-rF �+9� � __..-moi'.. T �. �. -��/► _ -
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Presented to — -----____-- Approved
Inspector _ _ ri67 _ ___��_ [] Disapproved
Date
CALL FOR REINSPECTION
CJ YES CANO
Z,9
BUILDING PERMIT APPLICATION TIGARD DATE- 19.----
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _
OR AS SHOWN'AND APPROVED IN THE ACCQMu.1NYING Pi AtjS NDSPE911ICATIONS. OWNER PHO
tf
7?.67 (t� LOT NO-; . " L.l.,--_--LL:,
OWNER � erg k It++! JOB ADDRESS .�._-.---
-- - ARCHITECT
ENGINEER
BUILDER 'S"'r _.� ADDRESS jr` Hirai `'t•r'iCdtt4'[ `^ DESIGNER :P,night*9
STRUCTURE_ [7 NEW _ ❑ REMODEL ❑ ADDITION__ ❑ REPAIR _it RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
Cl RESIDENCE CJ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS C7 PATIO El CARPORT ❑ GARAGE ❑ SYORAGE ❑ SLAB❑ FENCE
OCCUPANCY ._. LAND USE ZONE BLDG.TYPE''� C, ^FIRE ZONE--PLAN CHECK BY--ttvh .HEAT—r ler
.—
t,r1jr ains�t. b�ilily ,iwelling v/Attacj1P..r'_•,1TF�<`c .- -- �P.,4�tC/Ct"l9 1 �°�f1+3•
Mrl ACTA('t,}'.
> a91':/ -- '3'at()•O(i � r�7fr8ls',.E! S;?`i :�q . ft .
SEWERPERMITM _ -- -- - - -- - -- - -._--
OCC.LOAD FLOOR LCAD +! HEIGHT 1 ' NO.STORIES ' AREA 1" 1 I NO.BEDROOMS VALUE -
BUILDING DEPARTMENT SET BACKS FRONT REAR �1► LEFT SIDE ->!lR a� RIGHT SIDE --�
—
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGI)LATIONS CONTAINED IN THE BUILDING CUD[, 70NING
I -PEGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND It IS t EREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSI1ANCZ Of THIS PERMIT DOES NOT WAIVE
Sub total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS Te HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND Ht_ATING.
State Tax •_ SDC �AUU.
I. --
Total --- PDCN It i U ii.CT!!APPLICANTON AGENT—-- --�_
B 1
_ Receipt No.
----- --- - PHONF
Approved A D 88
..
DATE INSP. TYPE INSPECTION REMARKS I PLUMBING DATE
ContractoNo.
_ Cs .S '/r '`
�•2 �� �t�,. _— Permit Nu. ,Cej
– �z '\y
Rough-in
1 - Fixture
Final
-S2i_ / _ HEATING
Contractor
Gas or Oil
Rough-in
Final
5 g W E R
Final —T 2
-- – -- – –� DRIVEWAY Final
Stuim Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
DLUG DEPT,FIN AL TFMPORAY CERTIFICATED
FCC;UPANCY
CI`RTIFICATE OCCUPANr.Y Final
Landscaping
Zoning Final
/Vo 7Z
AWil-DING PERMIT APPLIATION TIGARD DAT 19
THE UNDERSIGNED HEREBY APPLIES FOR A FAIT FOR TETE WORK HEREIN DICATED BUILDER PHONE
bz8 X33
ORAS SHOWN AND APPROV,f-DIN THE ACCOI ANYING PLANS AND SPEC OWNER P 0 '
GU � LOT NO. �-
O`lJNEP.
9*w l ADDRESS • FI�S� • '`�4W DESIGNER F+Ii p TS V1alf. jlf�A1
BUILDER - ---� "
v �_ REPAIR ❑ 7EINEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
STRUCTURE �Q NEW ❑ REMODEL ❑ ADDIT'IOIJ � � -- ----
RESIDENCE
—❑-tCOMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS ❑ PATIO ❑ CARPORT Cl GARAGE G STORAGE ❑ SLAOrl rENCE
�
PANCY LAND USE ZOP',E _BLDG.TYPE _ FIRE ZONE PIJ1N CHECK BY
:
SEWER PERMIT
M _ � __�.-�_ - -e.► ___-_ ..._ -
OCC.LOAD FLOOR LOAD HEIGHT_ _/r3 NO.STORIES�l_ AREA I X 10 NO.BEDROOMS VA.LU= tj 00
BUILDING DEPARTMENT SETBACKS -FRONT 2Z HEAR _*33 LEFT SICE Z RIGHTSIDE _ 7
Permit -pV THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZOWNG
- w 7 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT TPE
``
Plan Check /•! S• GQ WORK WILL BE DONE IN ACCOFlDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
- -- �- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER.1111T DOES NOT WAIVE
Subtotal �_-(0 Q RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS LICENSE_SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING_
Stam Tax 4J
SDC-
TotalPDCN
-APPLICANTOR -- --- - __.._-- ----
BYReceipt
'— No. ADDfiESS � �� PHONE
Approved
SDC —
PDC
SEWER CONNECTION S el767 �y� �0
SEWER INSIaECTION $
SEWER SURCHARGE
- - ---gy l�� 31 -
18-6 x 24 44-4
21- c. xsa 'Ito
17- x 2- 34-
2
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P+_OR TANT MESIiiA0_1
F0R_ - ,1
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DATE ---TIME
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.
OF_... --
PHONE_--� —
AREA CODE NUMBER EXTENSION
TELEPHONED — PLEASE CALL
CAME TO SEE YOU - WILL CALL AGAIN $
WANTS TO SEE YOU� RUSH
--y
RETURNED YgUR CALL -- I RPECIAL ATTENTION-_--_ ..__
MESSAGE
L—
SIGNED -
Lrn�u
T'QPS FORM 30OPS
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